Individual
JEUNIECE SAMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2180 MAIN ST, WAILUKU, HI 96793-1625
(808) 242-6464
Mailing address
2180 MAIN ST, WAILUKU, HI 96793-1625
(808) 242-6464
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD-22073
HI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/12/2018
Last updated
11/03/2021
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