Individual
TED MASAO IKARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2575 NORTHWINDS PKWY, ALPHARETTA, GA 30009-2232
(808) 255-4455
Mailing address
PO BOX 129, HONOMU, HI 96728-0129
(808) 255-4455
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
145029
OH
Other
Enumeration date
09/19/2022
Last updated
09/19/2022
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