Organization
PANIOLO PEDIATRIC AND FAMILY MEDICINE INC
Active
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
Update your record
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