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Organization

PANIOLO PEDIATRICS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRETT COLIN FERGUSON MD (SOLE MEMBER)
(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

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
MD16732
HI

Other

Enumeration date
04/27/2015
Last updated
04/27/2015
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