Provider Demographics
NPI:1609894658
Name:ABBOTT, EDWARD FRANCIS (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:FRANCIS
Last Name:ABBOTT
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:PO BOX 10188
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85271-0188
Mailing Address - Country:US
Mailing Address - Phone:480-330-0189
Mailing Address - Fax:
Practice Address - Street 1:3-3420 KUHIO HWY, SUITE B
Practice Address - Street 2:KAUAI MEDICAL CLINIC
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1098
Practice Address - Country:US
Practice Address - Phone:808-245-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD3019207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D36475Medicare UPIN