Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 04-28402 | KS |
N | 208600000X | Surgeon | 04-28402 | KS |
Y | 2086S0102X | Surgical Critical Care | 078646 | GA |
NPI | 1205935624 |
---|---|
Provider Name | Dr. Kahdi F Udobi |
First Address | Atlanta, GA 30310-1458 |
Second Address | Atlanta, GA 30303-3031 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 08/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100345850A | (05) | KS |
204755102 | (05) | MO |
25911010 | BCBS KANSAS CITY (01) | MO |
372600 | FIRSTGUARD (01) | KS |
H01669 | (02) |