Provider Demographics
NPI:1609990290
Name:ABE, KEITH KEN (MD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:KEN
Last Name:ABE
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 1:1319 PUNAHOU ST STE 999
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-1077
Mailing Address - Country:US
Mailing Address - Phone:808-947-1402
Mailing Address - Fax:
Practice Address - Street 1:1319 PUNAHOU ST STE 999
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1077
Practice Address - Country:US
Practice Address - Phone:808-947-1402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA86333208000000X, 2084N0402X
HIMD-12767208000000X, 2084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics