Provider Demographics
NPI:1790980837
Name:ENOS, ROSALYN KEANI (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSALYN
Middle Name:KEANI
Last Name:ENOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:702 S BERETANIA ST STE B100
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2581
Mailing Address - Country:US
Mailing Address - Phone:808-538-2701
Mailing Address - Fax:
Practice Address - Street 1:1301 PUNCHBOWL ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2402
Practice Address - Country:US
Practice Address - Phone:808-691-4271
Practice Address - Fax:808-691-4045
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI4568207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI4568OtherTEMPORARY STATE LICENSE
HI14360OtherSTATE MEDICAL LICENSE