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 1:4300 N POINT PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-4102
Mailing Address - Country:US
Mailing Address - Phone:770-442-1911
Mailing Address - Fax:
Practice Address - Street 1:1719 RUSSELL PKWY STE 700
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-5765
Practice Address - Country:US
Practice Address - Phone:478-328-7674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA63745207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA605406OtherHEALTH AMERICA ADVANTRA
PA101487861Medicaid
PA000000213326OtherUNISON
PA000000213329OtherUNISON
PAP00435860OtherRR MEDICARE
PA1788855OtherBCBS
PA4279313OtherCIGNA
PAP006393OtherGATEWAY
PA000000213326OtherUNISON
PA096106V38Medicare PIN