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THERUVATH, ILKA DIETLINDE       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
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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