Provider Demographics
NPI:1043468275
Name:UMERAH, NNAEMEKA M (MD)
Entity Type:Individual
Prefix:DR
First Name:NNAEMEKA
Middle Name:M
Last Name:UMERAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4050 RIVERSIDE DRIVE
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-1805
Mailing Address - Country:US
Mailing Address - Phone:478-746-2888
Mailing Address - Fax:478-746-2889
Practice Address - Street 1:112 ARKWRIGHT LNDG
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-1364
Practice Address - Country:US
Practice Address - Phone:478-746-2888
Practice Address - Fax:478-746-2889
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-29
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA63974207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003000004BMedicaid
GA003000004CMedicaid
GA003000004BMedicaid
GA003000004CMedicaid