Provider Demographics
NPI:1427607381
Name:UMANAH, MICHAEL ANDREWS
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ANDREWS
Last Name:UMANAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3540 NEVIN BROOK RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-3900
Mailing Address - Country:US
Mailing Address - Phone:704-222-7151
Mailing Address - Fax:704-532-4638
Practice Address - Street 1:1404 BEATTIES FORD RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28216-4574
Practice Address - Country:US
Practice Address - Phone:704-222-7151
Practice Address - Fax:704-532-4638
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide