Provider Demographics
NPI:1881769156
Name:MILLARD, ROBERT JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:JOSEPH
Last Name:MILLARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4643 WAIMEA CANYON DRIVE
Mailing Address - Street 2:KAUAI VETERANS MEMORIAL HOSPITAL
Mailing Address - City:WAIMEA
Mailing Address - State:HI
Mailing Address - Zip Code:96796
Mailing Address - Country:US
Mailing Address - Phone:808-338-9444
Mailing Address - Fax:808-338-9235
Practice Address - Street 1:4643 WAIMEA CANYON DRIVE
Practice Address - Street 2:KAUAI VETERANS MEMORIAL HOSPITAL
Practice Address - City:WAIMEA
Practice Address - State:HI
Practice Address - Zip Code:96796
Practice Address - Country:US
Practice Address - Phone:808-338-9444
Practice Address - Fax:808-338-9235
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD 13854207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIMD 13854OtherPHYSICIAN LICENSE
HIE08037OtherCSC#
TN40665OtherPHYSICIAN LICENSE
TN40665OtherPHYSICIAN LICENSE