Healthcare Provider Details

I. General information

NPI: 1265434252
Provider Name (Legal Business Name): UMA JAMCHED MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 02/26/2021
Certification Date: 02/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 NORTHSIDE FORSYTH DR SUITE 210
CUMMING GA
30041-7668
US

IV. Provider business mailing address

PO BOX 2487
CUMMING GA
30028-6505
US

V. Phone/Fax

Practice location:
  • Phone: 770-887-5553
  • Fax: 770-781-2375
Mailing address:
  • Phone: 770-781-6386
  • Fax: 770-781-6374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number053555
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: