ITAUMA UDOSEN (NPI# 1265793616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265793616 |
| Entity Type | Individual |
| Full Name | ITAUMA UDOSEN |
| Credential | DO |
| Practice Address |
2745 Dekalb Medical Pkwy Ste 110 Lithonia GA 30058-4933 |
| Practice Telephone | 7705932382 |
| Practice Fax Number | 6785142527 |
| Mailing Telephone | 7705932382 |
| Enumeration Date | 2012-06-01 |
| Last Update Date | 2020-04-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 078910 | GA | Allopathic & Osteopathic Physicians |
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
78910 | GA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1324 Highway 138 Sw, Riverdale, GA 302961404 | (770) 907-4949 |
| Street Address |
2745 DEKALB MEDICAL PKWY STE 110 |
| City | LITHONIA |
| State | GA |
| Zip Code | 30058-4933 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932495215 | Candace Charysse White | Family Medicine | 2745 Dekalb Medical Pkwy Ste 110, Lithonia, GA 30058-4933 | 2011-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821603606 | Sherenda Lashawn Ellis | Contractor | 1859 Petite Lane, Lithonia, GA 30058 | 2020-09-09 |
| 1477186807 | Reset Recovery Health Center LLC | Substance Abuse Rehabilitation Facility | 6978 Main St, Lithonia, GA 30058 | 2020-02-13 |
| 1346726122 | Myorganics | Spec/Tech, Pathology | 5910 Shadow Rock Dr, Lithonia, GA 30058 | 2018-07-16 |
| 1699251884 | Enriching Medical Transport | Ambulance | 2260 Lithonia Industrial Blvd., Ste N-b, Lithonia, GA 30058 | 2018-07-11 |
| 1841789914 | Milner Vein and Vascular LLC | Surgery | 5700 Hillandale Dr Ste 150, Lithonia, GA 30058 | 2018-05-04 |
| 1215451265 | Brittany Rawlings | Home Health | 6127 Howell Ridge, Lithonia, GA 30058 | 2017-08-01 |
| 1982125571 | Bella Intellectum, LLC | Technician/Technologist | 6803 Edmonton Ct., Lithonia, GA 30058 | 2017-07-05 |
| 1528589397 | Arlene Dennis | Registered Nurse | 6022 Arnor Links Road, Lithonia, GA 30058 | 2017-07-03 |
| 1417401746 | Two Caring Hands Private Home Care | Home Health | 1959 Singers Way, Lithonia, GA 30058 | 2016-08-03 |
| 1518347467 | Ortho Injury and Wellness Center Inc. | Clinic/Center | 6148 A Covington Hwy, Lithonia, GA 30058 | 2015-06-05 |
| Find all providers in zip 30058 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306108279 | Casey Wagner | Family Medicine | 7813 Spivey Station Blvd Ste 220, Jonesboro, GA 30236 | 2012-06-15 |
| 1831422682 | Koji Nishimura | Family Medicine | Commander, Usameddac and Martin Army Community Hospital, 7950 Martin Loop, Fort Benning, GA 31905 | 2009-09-11 |
| 1073787305 | Mark James Sakr | Family Medicine | 3400 Old Milton Pkwy Ste C190, Alpharetta, GA 30005-4481 | 2008-04-17 |
| 1104009059 | Northeast Georgia Physicians Group, Inc. | Family Medicine | 115 Towne Center Pkwy, Suite 113, Hoschton, GA 30548-2213 | 2007-12-14 |
| 1366549073 | Michael Joseph Huey | Family Medicine | Emory University Student Health Services, 1525 Clifton Road, Atlanta, GA 30322-0001 | 2006-09-17 |
| 1942234281 | Charles Edward Garten II | Family Medicine | 3200 Downwood Cir Nw Ste 340, Atlanta, GA 30327-1605 | 2006-07-11 |
| 1477597979 | John M. Henderson Sr. | Family Medicine | 1900 10th Ave Suite 320, Columbus, GA 31901 | 2006-06-15 |
| 1609843481 | Tracy R Ray | Family Medicine | 1305 Jennings Mill Rd Ste 110, Watkinsville, GA 30677-7241 | 2006-03-01 |
| 1982679684 | John Michael Buchanan | Family Medicine | 3575 Braselton Hwy, Dacula, GA 30019-1155 | 2006-02-17 |
| 1770562852 | Neeru Jayanthi | Family Medicine | 6335 Hospital Pkwy Ste 302, Emory Orthopaedics, Sports, Spine, Johns Creek, GA 30097-5712 | 2006-01-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.