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NPI Code Detail

MEDICARE: UMA T DAYA P.A.

MEDICARE: UMA T DAYA P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant5779GA

General Provider Information

NPI Number : 1003132911
Entity Type Code : Individual
Provider Name (Legal Business Name) : UMA T DAYA P.A.
Provider Business Mailing Address
First Line : PO BOX 307
Second Line :
City : CUMMING
State : GA
Zip : 30028-0307
Country : US
Telephone Number : 770-887-1668
Fax Number : 770-720-7384
Provider Business Practice Location Address
First Line : 220 OAKSIDE LN
Second Line :
City : CANTON
State : GA
Zip : 30114-6413
Country : US
Telephone Number : 678-807-1050
Fax Number : 770-720-7384
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2010
Last Update Date : 04/17/2017

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