Mrs Ketra Shelly Ikezuagu, MD is a
Family Medicine physician based in Put-in-bay, Ohio. Mrs Ketra Shelly Ikezuagu is licensed to practice in Ohio (license number 35129203) and her current practice location is 528 Catawba Avenue, Put-in-bay, Ohio. She can be reached at her office (for appointments etc.) via phone at
(419) 285-2401.
NPI number for Mrs Ketra Shelly Ikezuagu is 1164672366 and her current mailing address is 2200 Jefferson Ave, Toledo, Ohio. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1164672366.
Physician's Profile
Full Name | Mrs Ketra Shelly Ikezuagu |
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Gender | Female |
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Speciality | Family Medicine |
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Location | 528 Catawba Avenue, Put-in-bay, Ohio |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1164672366
- Provider Enumeration Date: 09/24/2008
- Last Update Date: 05/04/2017
Medical Identifiers
Medical identifiers for Mrs Ketra Shelly Ikezuagu such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1164672366 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 35129203 (Ohio) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Ketra Shelly Ikezuagu is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mrs Ketra Shelly Ikezuagu, MD 2200 Jefferson Ave, Toledo, OH 43604-7101 Ph: (419) 285-2401 | Mrs Ketra Shelly Ikezuagu, MD 528 Catawba Avenue, Put-in-bay, OH 43456 Ph: (419) 285-2401 |
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