Provider Demographics
NPI:1770645608
Name:TENHAVE, ANDREW GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:GEORGE
Last Name:TENHAVE
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 1:62-3600 AMAUI PL
Mailing Address - Street 2:# 3202
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-7734
Mailing Address - Country:US
Mailing Address - Phone:808-987-7608
Mailing Address - Fax:
Practice Address - Street 1:62-3600 AMAUI PL
Practice Address - Street 2:# 3202
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-7734
Practice Address - Country:US
Practice Address - Phone:808-987-7608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54840207Q00000X
HIMD10584207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA54840OtherSTATE MEDICAL LICENSE