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General NPI Number Information
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NPI Number | 1386737138
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Entity Type | Individual
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Provider Name | SHAUNA PAYLOR M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 08/05/2024
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Provider Practice Location Address
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Address Line | 16-523 KEAAU PAHOA RD
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City | KEAAU
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State | HI
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Zip | 96749-8156
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Country | US
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Telephone | 808-932-3878
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Fax |
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Provider Business Mailing Address
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Address Line | 1190 WAIANUENUE AVE
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City | HILO
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State | HI
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Zip | 96720-2089
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Country | US
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Telephone | 808-932-3830
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD2005-0763
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD 17410
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License Number State | HI
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