Individual
DR. ADAM B KANIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
1 JARRETT WHITE RD, TRIPLER ARMY MEDICAL CENTER, ATTN MCHK-QS, TAMC, HI 96859-5001
(808) 433-2460
(808) 433-1558
Mailing address
1 JARRETT WHITE RD, TRIPLER ARMY MEDICAL CENTER, ATTN MCHK-QS, TAMC, HI 96859-5001
(808) 433-2460
(808) 433-1558
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
30001
IA
208000000X
Pediatrics Physician
30001
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0116129
—
IA
01
—
17019
WELLMARK BCBS
IA
Enumeration date
09/16/2005
Last updated
09/10/2021
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