Provider Demographics
NPI:1669085924
Name:EKARIKA, SHELITA
Entity type:Individual
Prefix:
First Name:SHELITA
Middle Name:
Last Name:EKARIKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4235 OAKNOLL CIR
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-5547
Mailing Address - Country:US
Mailing Address - Phone:678-860-1755
Mailing Address - Fax:
Practice Address - Street 1:4235 OAKNOLL CIR
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-5547
Practice Address - Country:US
Practice Address - Phone:678-860-1755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-26
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor