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Individual
STEPHEN CRAWFORD IKEDA
Active
Individual
STEPHEN CRAWFORD IKEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
73133
MA
2084P0802X
Addiction Psychiatry Physician
73133
MA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
73133
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J11337
BLUE CROSS
MA
Enumeration date
07/08/2006
Last updated
12/20/2011
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