Healthcare Provider Details

I. General information

NPI: 1548877400
Provider Name (Legal Business Name): SHAWN W MILHAUSER PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2020
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10435 REED ST STE 100
WESTMINSTER CO
80021-6099
US

IV. Provider business mailing address

2100 FRANKLIN ST STE 355
OAKLAND CA
94612-3140
US

V. Phone/Fax

Practice location:
  • Phone: 720-669-6682
  • Fax:
Mailing address:
  • Phone: 844-234-7741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085.007894
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA0008866
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: