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
Phone: (808) 315-1886
Fax: (808) 935-9259
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700088846 | NPPES |
| Alaska | MEDICAID | 1574708 |
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