Provider Demographics
NPI:1730425836
Name:BAYDO, MICHELLE (LAC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:BAYDO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6240
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-6240
Mailing Address - Country:US
Mailing Address - Phone:808-937-5575
Mailing Address - Fax:
Practice Address - Street 1:65-1206 MAMALAHOA HWY
Practice Address - Street 2:BUILDING 2, SUITE 6
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-7303
Practice Address - Country:US
Practice Address - Phone:808-937-5575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIACU-886171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist