Organization
PANIOLO PEDIATRIC AND FAMILY MEDICINE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT C. FERGUSON MD (PRESIDENT)
(808) 887-6543
Entity
Organization
Contact information
Practice address
64-1032 MAMALAHOA HWY STE 204, KAMUELA, HI 96743-8441
(808) 887-6543
(808) 887-6294
Mailing address
PO BOX 6149, KAMUELA, HI 96743-6149
(808) 887-6543
(808) 887-6294
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD18820
HI
208000000X
Pediatrics Physician
Primary
MD16732
HI
Other
Enumeration date
02/26/2018
Last updated
03/17/2018
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