Provider Demographics
NPI:1548582539
Name:MENES, KERIC (MD)
Entity Type:Individual
Prefix:
First Name:KERIC
Middle Name:
Last Name:MENES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 S BERETANIA ST
Mailing Address - Street 2:SUITE 201-202
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-1149
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1575 S BERETANIA ST
Practice Address - Street 2:SUITE 201-202
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1149
Practice Address - Country:US
Practice Address - Phone:808-946-1712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-18
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI18583207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZR71458OtherARIZONA MEDICAL BOARD