Itauma Udosen
CAEDEL MEDICAL GROUP


Address: 101 Devant St, Suite 803, Fayetteville, GA 30214-2716
Phone: 6782160342

Itauma Udosen (NPI# 1265793616, PAC ID# 2062637739) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.

Physician Overview

Nation Provider ID (NPI) 1265793616
PAC ID by PECOS 2062637739
Professional Enrollment ID I20171017000872
Full Name Itauma Udosen
Organization Legal Name CAEDEL MEDICAL GROUP
Address 101 Devant St
Suite 803
Fayetteville
GA 30214-2716
Phone Number 6782160342
Gender F
Medical School PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Graduation Year 2012
Primary Specialty FAMILY MEDICINE
Secondary Specialties SPORTS MEDICINE
Group Practice PAC ID 0648258988
Number of Group Practice Members 4
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
110165 SOUTHERN REGIONAL MEDICAL CENTER

Other Locations

Address Phone Organization
101 Devant St, Suite 803, Fayetteville, GA 30214-2716 6782160342 CAEDEL MEDICAL GROUP
1324 Hwy 138, Riverdale, GA 30296-1404 7709074949 CAEDEL MEDICAL GROUP

Organization Information

Organization Legal Name CAEDEL MEDICAL GROUP
Physicians 4

Physicians with the same organization

Name Specialty Organization Address
Lulu Sherrie Mitchell Physician Assistant Caedel Medical Group 1324 Hwy 138, Riverdale, GA 30296-1404
Claire K Willie Internal Medicine Caedel Medical Group 101 Devant St, Suite 803, Fayetteville, GA 30214-2716
James Oliviere Jr. Family Medicine Caedel Medical Group 1324 Hwy 138, Riverdale, GA 30296-1404

Office Location

Street Address 101 DEVANT ST
SUITE 803
City FAYETTEVILLE
State GA
Zip 30214-2716

Physicians in the same location

Name Specialty Organization Address
Linda M Foltz Psychologist, Clinical 101 Devant St, Suite 903, Fayetteville, GA 30214-2718
Claire K Willie Internal Medicine Caedel Medical Group 101 Devant St, Suite 803, Fayetteville, GA 30214-2716
Mercedes Merritt Williams Psychologist, Clinical Populations and Interventions Team Company 101 Devant St, Suite 504, Fayetteville, GA 30214-2720
Ginari G Price Psychiatry 101 Devant St, Suite 504, Fayetteville, GA 30214-2720

Physicians in the same zip code

Name Specialty Organization Address
Megan Massey Nurse Practitioner Piedmont Providers LLC 1279 Hwy 54 W, Suite 100, Fayetteville, GA 30214
Connie T Dupre Internal Medicine Piedmont Medical Care Corporation 1267 W Hwy 54, Suite 5200, Fayetteville, GA 30214
Gregory Valentine Family Medicine 874 Lanier W Ave, Suite 210, Fayetteville, GA 30214
Byron F Harper Internal Medicine 106 Governors Square Prkwy, Fayetteville, GA 30214
Kayona Jones Moreland Nurse Practitioner Piedmont Cardiology of Atlanta, LLC 1267 Hwy 54 W, Suite 2100, Fayetteville, GA 30214
Paul Constantine Karagiannis Cardiovascular Disease (cardiology) Piedmont Cardiology of Atlanta, LLC 1267 Hwy 54 W, Suite 2200, Fayetteville, GA 30214
Kevin Yang Urology Georgia Urology, Pa 1336 Hwy 54 W, Fayetteville, GA 30214
Angela R Parker Nurse Practitioner Piedmont Cardiology of Atlanta, LLC 1267 Hwy 54 W, Suite 2100, Fayetteville, GA 30214
Kavita Perumal Krishnasamy Cardiac Electrophysiology Piedmont Cardiology of Atlanta, LLC 1267 Hwy 54 W, Suite 2200, Fayetteville, GA 30214
Rani Shah Cardiovascular Disease (cardiology) Piedmont Cardiology of Atlanta, LLC 1267 Hwy 54 W, Suite 2200, Fayetteville, GA 30214
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Competitor

Search similar physicians

City FAYETTEVILLE
Zip Code 30214
Specialty FAMILY MEDICINE
City + Specialty FAYETTEVILLE + FAMILY MEDICINE

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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