Provider Demographics
NPI:1639153422
Name:SYROP, TAMA LYNN (MD)
Entity Type:Individual
Prefix:MRS
First Name:TAMA
Middle Name:LYNN
Last Name:SYROP
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 1:6081 ENDDEN CT
Mailing Address - Street 2:STE. 501
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-1338
Mailing Address - Country:US
Mailing Address - Phone:770-447-1019
Mailing Address - Fax:
Practice Address - Street 1:4775 JIMMY CARTER BLVD
Practice Address - Street 2:STE. 201
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093-3760
Practice Address - Country:US
Practice Address - Phone:770-638-8899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA43135207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAG72537Medicare UPIN
GAGRP4008Medicare ID - Type Unspecified