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NPI Code Detail

MEDICARE: KEISUKE ABE

MEDICARE: KEISUKE ABE
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
1207P00000XEmergency Medicine Physician04-48472KS
2207PP0204XPediatric Emergency Medicine (Emergency Medicine) Physician04-48472KS

General Provider Information

NPI Number : 1972097848
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEISUKE ABE
Provider Business Mailing Address
First Line : 550 N HILLSIDE ST
Second Line :
City : WICHITA
State : KS
Zip : 67214-4910
Country : US
Telephone Number : 316-962-2000
Fax Number :
Provider Business Practice Location Address
First Line : 550 N HILLSIDE ST
Second Line :
City : WICHITA
State : KS
Zip : 67214-4976
Country : US
Telephone Number : 316-962-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2018
Last Update Date : 10/04/2024

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Directions to “ KEISUKE ABE ” Practice Location

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