MEDICARE: DR. KENNETH H KERN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	2580	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	A38529	OTHER	HI	HMSA

General Provider Information

NPI Number	:	1598758732
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH H KERN MD

Provider Business Mailing Address
First Line	:	PO BOX 27684
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96827-0684
Country	:	US
Telephone Number	:	808-595-7526
Fax Number	:	808-595-2363

Provider Business Practice Location Address
First Line	:	2011 OAHU AVE
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96822-2206
Country	:	US
Telephone Number	:	808-595-7526
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	07/08/2007

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