Healthcare Provider Details

I. General information

NPI: 1033524368
Provider Name (Legal Business Name): UMAMA ADIL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2014
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 MEMORIAL DR STE 100
DALTON GA
30720-8662
US

IV. Provider business mailing address

1107 MEMORIAL DR STE 100
DALTON GA
30720-8662
US

V. Phone/Fax

Practice location:
  • Phone: 706-529-3072
  • Fax: 706-529-3077
Mailing address:
  • Phone: 706-529-3072
  • Fax: 706-529-3077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number111494
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number036157133
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number111494
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number2021043053
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: