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NPI Code Detail

MEDICARE: DR. IKPEMOSI PROMISE SADO MD

MEDICARE: DR. IKPEMOSI PROMISE SADO MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramGA

General Provider Information

NPI Number : 1134061518
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. IKPEMOSI PROMISE SADO MD
Provider Business Mailing Address
First Line : 720 WESTVIEW DR SW
Second Line :
City : ATLANTA
State : GA
Zip : 30310-1458
Country : US
Telephone Number : 404-756-1356
Fax Number : 404-756-1313
Provider Business Practice Location Address
First Line : 720 WESTVIEW DR SW
Second Line :
City : ATLANTA
State : GA
Zip : 30310-1458
Country : US
Telephone Number : 404-756-1356
Fax Number : 404-756-1313
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2026
Last Update Date : 04/07/2026

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