person
Micah Shigenori Iticovici, MD
Student in an Organized Health Care Education/Training Program in Indianapolis, Indiana
NPI 1114667011

Micah Shigenori Iticovici is a Student in an Organized Health Care Education/Training Program based in Indianapolis, IN. Micah Shigenori Iticovici practices in Indianapolis, IN and has the professional credentials of MD. The NPI Number for Micah Shigenori Iticovici is 1114667011 and holds a License No. (Indiana).

The current practice location address for Micah Shigenori Iticovici is 355 W 16Th St Ste 2364, Indianapolis, IN and can be reached out via phone at 317-963-7288.

Location: 355 W 16Th St Ste 2364, Indianapolis, IN, 46202-2279
person
Provider Profile Details
NPI Number
1114667011
Provider Name
Micah Shigenori Iticovici
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
355 W 16Th St Ste 2364, Indianapolis, IN, 46202-2279
Phone Number
317-963-7288
Fax Number
Provider Enumeration Date
03/30/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
355 W 16Th St Ste 2364
City
State
Zip
46202-2279
Phone Number
317-963-7288
Fax Number
person
Provider Business Mailing Address Details
Address
355 W 16Th St Ste 2364
City
State
Zip
46202-2279
Phone Number
317-963-7288
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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