Provider Demographics
NPI:1750511432
Name:ODAMA, UNINIBILE O (MD)
Entity Type:Individual
Prefix:DR
First Name:UNINIBILE
Middle Name:O
Last Name:ODAMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2386 CLOWER ST
Mailing Address - Street 2:STE C105
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-6107
Mailing Address - Country:US
Mailing Address - Phone:678-344-0334
Mailing Address - Fax:678-344-0343
Practice Address - Street 1:210 NORTH STREET W, SUITE D
Practice Address - Street 2:LANDMARK NEPHROLOGY AND HYPERTENSION CLINIC
Practice Address - City:TALLADEGA
Practice Address - State:AL
Practice Address - Zip Code:35160
Practice Address - Country:US
Practice Address - Phone:256-283-9760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-16
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA79065207RN0300X
VA0101225794207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology