Dr Shallon Tore Craddock, MD, MPH | |
199 Ululani St, Hilo, HI 96720-2930 | |
(808) 315-1886 | |
(808) 935-9259 |
Full Name | Dr Shallon Tore Craddock |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 199 Ululani St, Hilo, Hawaii |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1700088846 | NPI | - | NPPES |
1574708 | Medicaid | AK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 7298 (Alaska) | Secondary |
208000000X | Pediatrics | 17956 (Hawaii) | Primary |
Entity Name | Hilo Medical Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1962584060 PECOS PAC ID: 1254422900 Enrollment ID: O20070809000268 |
Mailing Address | Practice Location Address |
---|---|
Dr Shallon Tore Craddock, MD, MPH 2250 Kaumana Dr, Hilo, HI 96720-1316 Ph: (808) 315-1519 | Dr Shallon Tore Craddock, MD, MPH 199 Ululani St, Hilo, HI 96720-2930 Ph: (808) 315-1886 |
Dr. Wanda G Meurs, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 120 Pauahi Street, Suite #305, Hilo, HI 96720 Phone: 808-969-3222 Fax: 808-961-0046 | |
Dr. Miki A Cain, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 1292 Waianuenue Ave, Hilo, HI 96720 Phone: 808-734-8400 | |
Dr. Brenda M K Camacho, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 183 Mohouli Street, Hilo, HI 96720 Phone: 808-935-1621 Fax: 808-935-5959 | |
Dr. Michael Treece, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1178 Kinoole St, Hilo, HI 96720 Phone: 808-961-4082 | |
Dr. Brian J Wilson, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 275 Ponahawai St, Suite 106, Hilo, HI 96720 Phone: 808-961-0022 Fax: 808-969-3852 | |
Dr. Ty Jordan Tsuji De Silva, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 183 Mohouli St, Hilo, HI 96720 Phone: 808-935-1621 | |
Dr. Joseph A D'angelo, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 460 Kilauea Ave Ste 103, Hilo, HI 96720 Phone: 808-333-3600 Fax: 808-933-2983 |