Organization
IKMD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IGOR KRAVCHENKO MD (SOLE OWNER)
(602) 395-0718
Entity
Organization
Contact information
Practice address
18701 N 67TH AVE, GLENDALE, AZ 85308-7100
(623) 561-1000
Mailing address
15345 N SCOTTSDALE RD UNIT 3063, SCOTTSDALE, AZ 85254-3048
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
07/03/2018
Last updated
07/03/2018
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