MEDICARE: DR. CLARE AMIRA OMEKAM MD

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
1	207RR0500X	Rheumatology Physician	105145	GA

General Provider Information

NPI Number	:	1831659184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CLARE AMIRA OMEKAM MD

Provider Business Mailing Address
First Line	:	PO BOX 31665
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28231-1665
Country	:	US
Telephone Number	:	843-793-6980
Fax Number	:

Provider Business Practice Location Address
First Line	:	1955 LAKE PARK DR SE STE 100
Second Line	:
City	:	SMYRNA
State	:	GA
Zip	:	30080-8855
Country	:	US
Telephone Number	:	470-785-2333
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2019
Last Update Date	:	05/28/2026

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