Basic Information
| Provider Information | |||||||||
| NPI: | 1477198695 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | UMSTEAD | ||||||||
| FirstName: | SYDNEY | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 914 COLLIER RD NW APT 4002 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303182581 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7068403302 | ||||||||
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| Practice Location | |||||||||
| Address1: | 95 COLLIER RD NW STE 5015 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303091721 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4046055699 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/12/2019 | ||||||||
| LastUpdateDate: | 02/11/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 9520 | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.