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JERRY TAKUBALA KENA M.B.B.S

>> Internal Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1568896397

Individual Registrant:
 JERRY TAKUBALA KENA M.B.B.S
Gender: M
Not Sole Proprietor

Location and contact information for practice:
PO BOX LBJ  PAGO PAGO, AS 96799-0010 US
Tel: 684-633-1222  Fax: 684-633-2893

Contact information for business:
PO BOX LBJ  PAGO PAGO, AS 96799-0010 US
Tel: 684-633-1222  Fax: 684-633-2893

Registration Information:
NPI: 1568896397
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207R00000XAllopathic & Osteopathic Physicians
Internal Medicine
AS2060-C

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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