Organization
SUNSHINE PEDIATRIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHALLON TORE CRADDOCK M.D. (OWNER)
(808) 315-1519
Entity
Organization
Contact information
Practice address
199 ULULANI ST, HILO, HI 96720-2930
(808) 315-1886
Mailing address
2250 KAUMANA DR, HILO, HI 96720-1316
(808) 315-1886
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
MD17956
HI
Other
Enumeration date
11/07/2016
Last updated
11/07/2016
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