Provider Demographics
NPI:1942692165
Name:KE, ARTHUR JR (AA)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:
Last Name:KE
Suffix:JR
Gender:M
Credentials:AA
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:17056 NW 16TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1355
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1150 VARNUM STREET, NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2104
Practice Address - Country:US
Practice Address - Phone:202-854-4041
Practice Address - Fax:202-854-4034
Is Sole Proprietor?:No
Enumeration Date:2015-02-25
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAA256367H00000X
DCAA000079367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014583900Medicaid
FL014583900Medicaid