Adam B Kanis, MD, PHD
Individual provider Active NPI Clinical Genetics (M.D.) Physician · Tamc, HI
NPI 1174518955 · NPPES record last updated Sep 10, 2021
Key facts
- NPI
- 1174518955
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Genetics (M.D.) Physician 207SG0201X
- License
- 30001 (IA)
- Practice address
- 1 Jarrett White Rd
Tripler Army Medical Center, Attn MCHK-QS
Tamc, HI 96859-5001 - Phone
- (808) 433-2460
- Fax
- (808) 433-1558
- NPI assigned
- Sep 16, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine, Doctor of Philosophy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 30001 | IA | |
| Clinical Genetics (M.D.) Physician | 207SG0201X | 30001 | IA | Yes |
Addresses
Primary practice location
1 Jarrett White Rd
Tripler Army Medical Center, Attn MCHK-QS
Tamc, HI 96859-5001
Mailing address
1 Jarrett White Rd
Tripler Army Medical Center, Attn MCHK-QS
Tamc, HI 96859-5001
Phone (808) 433-2460
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0116129 | Medicaid | IA | |
| 17019 | Other | IA | WELLMARK BCBS |
Other providers in Tamc, HI
- Eleanor Ruth Hastings
- Kirsten Mae Holmes
- Susanna Naomi Holt
- Jordanna Mae Hostler
- William James Howard III
- Dyan M Kiyuna-Uchida
- Raja S Kolli
- Lisa M Lute
- Michelle Lea Lutter
- John Dale Mabey Jr.
All providers in Tamc, HI · Clinical Genetics (M.D.) Physician in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.