Healthcare Provider Details

I. General information

NPI: 1992717854
Provider Name (Legal Business Name): ALEX M ABERIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 05/20/2022
Certification Date: 05/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27-641 KAIEIE RD
PAPAIKOU HI
96781-7717
US

IV. Provider business mailing address

27-641 KAIEIE RD
PAPAIKOU HI
96781-7717
US

V. Phone/Fax

Practice location:
  • Phone: 808-936-0949
  • Fax: 808-657-4450
Mailing address:
  • Phone: 808-936-0949
  • Fax: 808-657-4450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD9667
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: