Individual
DR. BEAU DYLAN K FERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1356 LUSITANA ST, 7TH FLOOR, HONOLULU, HI 96813
(808) 586-2910
Mailing address
91-2141 FORT WEAVER RD, EWA BEACH, HI 96706-1993
(808) 691-3190
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD-18036
HI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/10/2012
Last updated
06/27/2018
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