Provider Demographics
NPI:1265434252
Name:JAMCHED, UMA (MD)
Entity type:Individual
Prefix:
First Name:UMA
Middle Name:
Last Name:JAMCHED
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:PO BOX 2487
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30028-6505
Mailing Address - Country:US
Mailing Address - Phone:770-781-6386
Mailing Address - Fax:770-781-6374
Practice Address - Street 1:1400 NORTHSIDE FORSYTH DR
Practice Address - Street 2:SUITE 210
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-7668
Practice Address - Country:US
Practice Address - Phone:770-887-5553
Practice Address - Fax:770-781-2375
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA053555207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA5819027847AMedicaid
11BOXFBMedicare ID - Type Unspecified
H95376Medicare UPIN