Most Relevant Information
Provider Data
| NPI Number: | 1003301144 |
| Provider Name: | IRAKLI TODUA MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/29/2018 |
| Last Updated: | 03/29/2022 |
Provider Practice Location
901 HEARTLAND RD STE 3800
SAINT JOSEPH
MO
645066201
Practice Location Phone/Fax
| Phone: | 8166714800 |
| Fax: |
Provider Mailing Location
5301 FARAON ST STE 120
SAINT JOSEPH
MO
645063512
Provider Mailing Phone/Fax
| Phone: | 8162711066 |
| Fax: | 8162716786 |