Healthcare Provider Details

I. General information

NPI: 1417901331
Provider Name (Legal Business Name): KEN C HOWAYECK DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 AOLOA ST
KAILUA HI
96734-3004
US

IV. Provider business mailing address

322 AOLOA STREET, #211
KAILUA HI
96734
US

V. Phone/Fax

Practice location:
  • Phone: 808-261-0304
  • Fax:
Mailing address:
  • Phone: 808-261-0304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO109
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: