Provider Demographics
NPI:1861487753
Name:GARDNER, SHERYL PAIGE (MD)
Entity Type:Individual
Prefix:DR
First Name:SHERYL
Middle Name:PAIGE
Last Name:GARDNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:95-1249 MEHEULA PKWY
Mailing Address - Street 2:SUITE B10
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-1779
Mailing Address - Country:US
Mailing Address - Phone:808-625-5277
Mailing Address - Fax:808-625-1985
Practice Address - Street 1:95-1249 MEHEULA PKWY
Practice Address - Street 2:SUITE B10
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-1779
Practice Address - Country:US
Practice Address - Phone:808-625-5277
Practice Address - Fax:808-625-1985
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-16
Last Update Date:2007-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HI5828207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH0000BDNDHMedicare PIN
HIC89024Medicare UPIN