| Youngerselfmd | |
|
3105 Creekside Village Dr Nw Ste 801 Kennesaw GA 30144-4218 | |
| (781) 475-2735 | |
| Not Available |
| Full Name | Youngerselfmd |
|---|---|
| Speciality | Internal Medicine |
| Location | 3105 Creekside Village Dr Nw Ste 801, Kennesaw, Georgia |
| Authorized Official Name and Position | Ndidiamaka O Obadan (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7814752735 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Youngerselfmd 3105 Creekside Village Dr Nw Ste 801 Kennesaw GA 30144-4218 Ph: (781) 475-2735 | Youngerselfmd 3105 Creekside Village Dr Nw Ste 801 Kennesaw GA 30144-4218 Ph: (781) 475-2735 |
| NPI Number | 1548918196 |
|---|---|
| Provider Enumeration Date | 03/14/2022 |
| Last Update Date | 07/14/2023 |
| Medicare PECOS PAC ID | 0244697399 |
|---|---|
| Medicare Enrollment ID | O20230605001109 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548918196 | NPI | - | NPPES |
| Provider Name | Ndidiamaka Obadan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225385248 PECOS PAC ID: 4981912847 Enrollment ID: I20230605001482 |
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