Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 036129893 | IL |
N | 207Q00000X | Family Doctor | 1568 | HI |
Y | 207RA0401X | Internist - Addiction Medicine | 1568 | HI |
NPI | 1841566064 |
---|---|
Provider Name | Shannon Price-Schwartz |
First Address | Kailua Kona, HI 96740-1752 |
Second Address | Kailua Kona, HI 96740 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2012 |
Last Update Date | 06/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
755449 | (05) | HI |