Organization
ISLAND DERMATOLOGY LLC
Active
Organization
ISLAND DERMATOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHELLIE R NORMAN APRN (MANAGING MEMBER)
(208) 640-3504
Entity
Organization
Contact information
Practice address
75-5995 KUAKINI HWY STE 443&445, KAILUA KONA, HI 96740-2144
(808) 323-2608
(808) 885-9793
Mailing address
PO BOX 2279, KAILUA KONA, HI 96745-2279
(808) 323-2608
(808) 885-9793
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
12/07/2018
Last updated
12/07/2018
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