Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | RN208137 | GA |
NPI | 1114285509 |
---|---|
Provider Name | Sameia Mohammed Udoji |
First Address | Atlanta, GA 30308-2208 |
Second Address | Atlanta, GA 30308-2208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2012 |
Last Update Date | 15/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3000298786 | (05) | GA |