Individual
INGA KHACHATUROVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1900 DON WICKHAM DR, MP SL ADMIN, CLERMONT, FL 34711-1979
(352) 536-8840
(352) 536-8841
Mailing address
1900 DON WICKHAM DR, MP SL ADMIN, CLERMONT, FL 34711-1979
(352) 536-8840
(352) 536-8841
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
ME119938
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012092000
—
FL
01
—
ME119938
MEDICAL LICENSE
FL
Enumeration date
07/13/2009
Last updated
11/15/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us