ODIANOSEN I OBADAN M.D NPI 1902200835

NPI Information

NPI: 1902200835
Provider Name: ODIANOSEN I OBADAN, M.D
Classification: Internal Medicine - 207RN0300X
Entity Type: Individual

Specialization: Nephrology

PECOS Registration: Yes

Address:
601 PROFESSIONAL DR STE 235A
LAWRENCEVILLE, GA
ZIP 30046
Phone: (470) 292-3957
Get Directions

Odianosen I Obadan, M.D is a nephrology internal medicine in Lawrenceville, GA. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. Odianosen I Obadan, M.D NPI is 1902200835. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

601 PROFESSIONAL DR STE 235A
LAWRENCEVILLE, GA
ZIP 30046-697
Phone: (470) 292-3957
Fax: (470) 292-3683

The NPI 1902200835 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/21/2014 and was last updated on 3/14/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207R00000X	Internal Medicine		84734	SOUTH CAROLINA	No
2	207RN0300X	Internal Medicine	Nephrology	MD61234746	WASHINGTON	No
3	207RN0300X	Internal Medicine	Nephrology	86371	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	847347	MEDICAID	SOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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