DR. RITA UDOM (NPI# 1710506233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710506233 |
| Entity Type | Individual |
| Full Name | DR. RITA UDOM |
| Credential | MD |
| Practice Address |
2795 Davis Rd Marietta GA 30062-6670 |
| Practice Telephone | 4049986825 |
| Mailing Telephone | 4049986825 |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2020-04-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
39505 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
2795 DAVIS RD |
| City | MARIETTA |
| State | GA |
| Zip Code | 30062-6670 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578051 | Pamela D Kretzmer | Social Worker | 3855 Shallowford Road, Suite 420, Marietta, GA 30062 | 2020-11-03 |
| 1932714680 | Michelle Chambless | Physical Therapist | Team Rehabilitation Ga01, LLC, 1401 Johnson Ferry Road, Suite 340, Marietta, GA 30062 | 2020-09-10 |
| 1700408887 | Life University | Chiropractor | 1323 Roswell Road, Marietta, GA 30062 | 2020-05-12 |
| 1104451160 | Sno Healthcare Group | Clinic/Center | 2424 Roswell Rd Ste 120, Marietta, GA 30062 | 2020-03-10 |
| 1811536212 | Sandy Plains Dental Group, PC | Dentist | 3460 Sandy Plains Rd, Suite 240, Marietta, GA 30062 | 2020-01-02 |
| 1073159034 | Magdala Tulcie Jodesty-jackson | Social Worker | 4343 Shalloword Road, Building H, Suite 4 Lower Level, Marietta, GA 30062 | 2019-11-25 |
| 1598235178 | Matthew Driggers | Counselor | 4343 Shallowford Rd C2, Marietta, GA 30062 | 2018-11-27 |
| 1750895785 | Emily Grace Minday | Counselor | 4343 Shallowford Road Building C, Suite 1 Lower Level, Marietta, GA 30062 | 2017-11-29 |
| 1477072122 | Jason Lee Amos | Speech-Language Pathologist | 3660 Chestnut Ridge Court, Marietta, GA 30062 | 2017-09-13 |
| 1346761376 | Marian Pomaah Opoku-agyeman | Nurse Practitioner | 4661 Andrea Pointe, Marietta, GA 30062 | 2017-06-29 |
| Find all providers in zip 30062 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720083066 | Raymond Bruce Henthorn | Emergency Medicine | 316 5th St, Marietta, OH 45750-3027 | 2005-06-14 |
| 1154424463 | Jon Khoury | Emergency Medicine | 55 Whitcher St Ne, Suite 160, Marietta, GA 30060-1155 | 2006-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528675956 | Nextgen Ems LLC | Emergency Medicine | 121 Tyre Dr, Mcdonough, GA 30253-8542 | 2020-09-29 |
| 1629463500 | Quoc Vinh Ngo | Emergency Medicine | Wellstar West Georgia Medical Center, 1504 Vernon Road, Lagrange, GA 30240 | 2015-03-30 |
| 1831539253 | Andrew Wesley White | Emergency Medicine | 1120 15th St # Af1006, Augusta, GA 30912-4500 | 2013-06-29 |
| 1013141118 | Darren Deandre Naugles | Emergency Medicine | 8920 Firestone Cir, Duluth, GA 30097-6627 | 2009-05-05 |
| 1437393667 | Donald R. Dalbey | Emergency Medicine | 3725 Sweetwater Drive, Cumming, GA 30041 | 2009-05-01 |
| 1346411667 | Harvey E Schuck | Emergency Medicine | 427 Brentwood Dr Ne, Atlanta, GA 30305-3204 | 2008-03-14 |
| 1639364011 | Srihari Rao Malempati | Emergency Medicine | 535 Trimble Lake Ct Ne, Atlanta, GA 30342-2481 | 2007-09-10 |
| 1306060264 | Gary L Godlewski | Emergency Medicine | 4755 Wesleyan Woods Dr, Macon, GA 31210-4410 | 2007-04-12 |
| 1710030002 | Robert Lee Carlson Jr. | Emergency Medicine | 3900 Legacy Park Blvd Nw, Suite C-100, Kennesaw, GA 30144-7412 | 2007-01-19 |
| 1487729992 | Lisa Tadayon | Emergency Medicine | 1000 John Fy Rd Ne, Atlanta, GA 30342-1606 | 2006-11-21 |
| 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.