Raphael Sopunim Udom
Raphael Sopunim Udom is a Registered Nurse in Decatur, Georgia. Licensed in Georgia. Registered with an NPI since 2024.
- Licensed in
- GA
- In the registry since
- 2024
Practice location Address checks out
1670 Clairmont RdDecatur, GA 30033-4004
Phone: (000) 000-0000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Registered Nurse (primary) | Taxonomy 163W00000X · Licence 241170 (GA) |
|---|
Record details
| NPI number | 1285467217 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | August 23, 2024 |
| Last updated in NPPES | August 23, 2024 |
| Certification date | August 23, 2024 |
| Mailing address | 3720 Long Lake Dr, Douglasville, GA 30135-7654 |
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