Provider Demographics
NPI:1497393953
Name:UMERAH FAMILY PRACTICE LLC
Entity Type:Organization
Organization Name:UMERAH FAMILY PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ANAYO
Authorized Official - Middle Name:
Authorized Official - Last Name:UMERAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-944-7914
Mailing Address - Street 1:112 ARKWRIGHT LNDG STE B
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 1:112 ARKWRIGHT LNDG STE B
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-16
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty