Craddock, Shallon Tore

Craddock, Shallon Tore is an individual health care provider with primary practice located at 199 Ululani St , Hilo HI 96720-2930. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Craddock, Shallon Tore can be contacted via phone (808) 315-1886.

Contact Information

Primary practice address
199 Ululani St Hilo HI 96720-2930
Fax: (808) 935-9259
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 7298 Alaska
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 17956 Hawaii

Profile Details

NPI number 1700088846
LBN Legal business name Craddock, Shallon Tore
Credentials M.D., M.P.H.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2007
Last updated Mar 7th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700088846 NPPES
Alaska MEDICAID 1574708

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