Most Relevant Information
Provider Data
| NPI Number: | 1003182148 |
| Provider Name: | ELIZABETH IKEDA |
| Entity Type: | Individual |
| Taxonomy Code: | 367H00000X |
| Specialty: | Anesthesiologist Assistant |
| License Number: | 006537 |
Most Important Dates
| Enumeration Date: | 03/22/2012 |
| Last Updated: | 08/15/2019 |
Provider Practice Location
1365 CLIFTON RD NE
ATLANTA
GA
30322
Practice Location Phone/Fax
| Phone: | 4047788311 |
| Fax: |
Provider Mailing Location
1365 CLIFTON RD NE
ATLANTA
GA
303221013
Provider Mailing Phone/Fax
| Phone: | 4047788311 |
| Fax: |