Individual
MRS. KETRA SHELLY IKEZUAGU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
528 CATAWBA AVENUE, PUT-IN-BAY, OH 43456
(419) 285-2401
Mailing address
2200 JEFFERSON AVE, TOLEDO, OH 43604-7101
(419) 285-2401
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35129203
OH
Other
Enumeration date
09/24/2008
Last updated
05/04/2017
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