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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

ITAUMA UDOSEN, DO

Active

ITAUMA UDOSEN, DO is a Sports Medicine healthcare provider located in LITHONIA, Georgia. NPI 1265793616 is currently active in the NPPES registry. Verify at CMS.

Sports Medicine · LITHONIA, GA

Registration Details

NPI Number
1265793616
Provider Type
Individual
Gender
Female
NPI Issued
Jun 1, 2012 (14.158387409898 yrs)
Last Updated
Jul 21, 2022
Licenses
078910 (GA)
78910 (GA)

Practice Information

Address
2745 DEKALB MEDICAL PKWY STE 110
LITHONIA, GA, 300584933
Browse GA providers · Browse ZIP 30058
Phone
7705932382
Fax
6785142527
Primary Specialty
Sports Medicine
207QS0010X
Additional Specialty
Sports Medicine
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.