Udosen, Itauma
Udosen, Itauma is an individual health care provider with primary practice located at 2745 Dekalb Medical Pkwy Ste 110 , Lithonia GA 30058-4933. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is her primary health care specialty. Udosen, Itauma can be contacted via phone (770) 593-2382.Contact Information
Primary practice address
2745 Dekalb Medical Pkwy Ste 110
Lithonia GA 30058-4933
Phone: (770) 593-2382
Fax: (678) 514-2527
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 078910 | Georgia |
| Allopathic & Osteopathic Physicians / Sports Medicine | 207QS0010X | 78910 | Georgia |
Profile Details
| NPI number | 1265793616 |
|---|---|
| LBN Legal business name | Udosen, Itauma |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 1st, 2012 |
| Last updated | Jul 21st, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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