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THERUVATH, ILKA DIETLINDE
Practice Address: PROVIDENCE ANESTHESIOLOGY ASSOCIATES
131PROVIDENCE RD
SUITE 200
CHARLOTTE NC 28207

Address last updated on 7/6/2021
Phone #: (704) 749-5800 x1101
Fax #:
County: NOT OKLAHOMA
License: 34077
Dated: 7/16/2018
Expires: 7/1/2021
License Type: Medical Doctor
Specialty: Anesthesiology
Pediatric Anesthesiology (Pediatrics)
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Med Hochschule Hannover, Hannover, Germany
Graduated: 11 / 2000
CME Year: 2021
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF ANESTHESIOLOGY - Pediatric Anesthesiology
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
PROVIDENCE ANESTHESIOLOGY ASSOCIATES
131PROVIDENCE RD
SUITE 200
CHARLOTTE NC 28207

Phone #: (704) 749-5800 x1101
Fax #:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:

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