Individual
DR. ILKA DIETLINDE THERUVATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., PH.D.
Contact information
Practice address
3735 GLENLAKE DR STE 250, CHARLOTTE, NC 28208-6866
(704) 749-5800
Mailing address
PO BOX 117661, ATLANTA, GA 30368-7661
(704) 749-5800
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2015-00804
NC
207L00000X
Anesthesiology Physician
29705
SC
Other
Enumeration date
04/18/2007
Last updated
04/17/2024
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