ODIANOSEN I OBADAN


Address: 601 Professional Dr Ste 235a, Lawrenceville, GA 30046-7697
Phone: 4702923957

ODIANOSEN I OBADAN (NPI# 1902200835) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1902200835
Entity Type Individual
Full Name ODIANOSEN I OBADAN
Credential M.D
Practice Address 601 Professional Dr Ste 235a
Lawrenceville
GA 30046-7697
Mailing Address Po Box 3877
Joliet
IL 60434-3877
Practice Telephone 4702923957
Practice Fax Number 4702923683
Mailing Telephone 8157416830
Mailing Fax Number 8157416832
Enumeration Date 2014-10-21
Last Update Date 2020-09-29
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207R00000X Internal Medicine 84734 SC Allopathic & Osteopathic Physicians
Y 207RN0300X Internal Medicine
Specialization: Nephrology
86371 GA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
SC 847347 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
129 N Washington St, Sumter, SC 291504949 8034346771
14 Richland Medical Park Dr Ste 320, Columbia, SC 292036896 8034346771

Office Location

Street Address 601 PROFESSIONAL DR STE 235A
City LAWRENCEVILLE
State GA
Zip Code 30046-7697

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NPI Name Taxonomy Address Enumeration
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1215550264 Mesun Health Services, Inc Skilled Nursing Facility 88 Johnson Rd. Building #2, Lawrenceville, GA 30046 2020-05-26
1306499785 Bryan Acosta Chiropractor 471 Scenic Hwy South, Lawrenceville, GA 30046 2019-07-24
1205308616 Belle Lumiere Cosmetics LLC Dermatology 753 Old Norcross Road, Lawrenceville, GA 30046 2018-12-24
1548730179 Alexis Nicole Robinson Nurse Anesthetist, Certified Registered 1000 Medical Center Boulevard, Lawrenceville, GA 30046 2018-11-27
1679060388 Christopher Puckett Student in an Organized Health Care Education/Training Program 665 Duluth Hwy Suite 501, Lawrenceville, GA 30046 2018-04-18
1457851255 Advanced Urology Institute of Georgia Urology 501 Crown Point Way, Lawrenceville, GA 30046 2018-02-19
1013447044 Pharmacy Investments of Lawrenceville, LLC Pharmacy 738 Old Norcross Road, Ste A, Lawrenceville, GA 30046 2017-06-13
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Taxonomy Information

Taxonomy Code 207RN0300X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Nephrology

Taxonomy Definition

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.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1063070654 Kidney Specialists of Georgia PC Internal Medicine 575 Professional Dr Ste 290, Lawrenceville, GA 30046-3347 2019-05-30
1417101189 Chetana Rondla Internal Medicine 595 Hurricane Shoals Road, N.w., Suite 100, Lawrenceville, GA 30046 2008-11-07
1346412012 Mark A Klausner Internal Medicine 2332 Town Ct N, Lawrenceville, NJ 08648-4709 2008-04-02
1023298981 Franklin D. Diaz, Md, PC Internal Medicine 601 A Professional Drive, Suite 200, Lawrenceville, GA 30045-3004 2007-11-08
1407999246 Franklin Daniel Diaz Internal Medicine 601a Professional Drive Ste 225, Lawrenceville, GA 30046-3325 2007-02-14
1295721124 Meena J. Kavil Internal Medicine 595 Hurricane Shoals Rd Nw Ste 100, Lawrenceville, GA 30046 2005-09-26
1700881612 Kirti K Shah Internal Medicine 605 Old Norcross Rd, Lawrenceville, GA 30045-4315 2005-06-16
1972507630 Li-kun Tu Internal Medicine 595 Hurricane Shoals Road Suite 100, Lawrenceville, GA 30046 2005-06-10
1306193016 Ewalola Ayo Ijaduola Internal Medicine 595 Hurricane Shoals Rd Nw Ste 100, Lawrenceville, GA 30046-8762 2012-08-13
1922390830 Vinod Raman Internal Medicine 595 Hurricane Shoals Rd Nw Ste 100, Lawrenceville, GA 30046-8762 2011-05-11
Find all providers in LAWRENCEVILLE

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City LAWRENCEVILLE
Zip Code 30046

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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