Provider Demographics
NPI:1104144484
Name:PATWARDHAN, UMA V (MD)
Entity type:Individual
Prefix:
First Name:UMA
Middle Name:V
Last Name:PATWARDHAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3495 PIEDMONT RD NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1717
Mailing Address - Country:US
Mailing Address - Phone:404-504-5678
Mailing Address - Fax:912-350-2156
Practice Address - Street 1:1000 JOHNSON FERRY RD
Practice Address - Street 2:KAISER PERMANENTE @ NORTHSIDE HOSPITAL
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1606
Practice Address - Country:US
Practice Address - Phone:404-851-8000
Practice Address - Fax:912-350-2156
Is Sole Proprietor?:No
Enumeration Date:2010-05-11
Last Update Date:2022-01-10
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Provider Licenses
StateLicense IDTaxonomies
GA070399207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003136139AMedicaid
GAP01210866OtherRAILROAD MEDICARE
SCGA1551Medicaid
GA202I111045Medicare PIN