Provider Demographics
NPI:1003986761
Name:UMERAH, ANAYO (MD)
Entity Type:Individual
Prefix:DR
First Name:ANAYO
Middle Name:
Last Name:UMERAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 ARKWRIGHT LNDG
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-1364
Mailing Address - Country:US
Mailing Address - Phone:478-746-2888
Mailing Address - Fax:478-746-2889
Practice Address - Street 1:4050 RIVERSIDE DR
Practice Address - Street 2:SUITE B
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-1805
Practice Address - Country:US
Practice Address - Phone:478-746-2888
Practice Address - Fax:478-746-2889
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA63745207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000000213326OtherUNISON
PA1788855OtherBCBS
PAP006393OtherGATEWAY
PAP00435860OtherRR MEDICARE
PA101487861Medicaid
PA4279313OtherCIGNA
PA000000213329OtherUNISON
PA605406OtherHEALTH AMERICA ADVANTRA
PA000000213326OtherUNISON
PA096106V38Medicare PIN