Healthcare Provider Details

I. General information

NPI: 1457456071
Provider Name (Legal Business Name): KENNETH M. ASH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 PUNAHOU ST
HONOLULU HI
96826-1001
US

IV. Provider business mailing address

1946 YOUNG ST SUITE 360
HONOLULU HI
96826-2150
US

V. Phone/Fax

Practice location:
  • Phone: 808-983-8387
  • Fax: 808-983-6392
Mailing address:
  • Phone: 808-973-7320
  • Fax: 808-973-7325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberMD-3525
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: