Organization
YOUTHFULMD INTEGRATIVE HEALTH LLC
Active
Other names
YoungerselfMD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NDIDIAMAKA O OBADAN MD (MEDICAL DIRECTOR)
(781) 475-2735
Entity
Organization
Contact information
Practice address
3105 CREEKSIDE VILLAGE DR NW STE 801, KENNESAW, GA 30144-4218
(781) 475-2735
Mailing address
3105 CREEKSIDE VILLAGE DR NW STE 801, KENNESAW, GA 30144-4218
(781) 475-2735
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RH0005X
Hypertension Specialist Physician
—
—
207RI0200X
Infectious Disease Physician
—
—
207RN0300X
Nephrology Physician
Primary
—
—
208M00000X
Hospitalist Physician
—
—
Other
Enumeration date
03/14/2022
Last updated
07/14/2023
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