Organization
LUMENMED LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. UDAY TATA MD (MEDICAL DIRECTOR)
(678) 571-0899
Entity
Organization
Contact information
Practice address
2138 SCENIC HWY N STE A, SNELLVILLE, GA 30078-6106
(678) 571-0899
Mailing address
2138 SCENIC HWY N STE A, SNELLVILLE, GA 30078-6106
(678) 571-0899
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
08/25/2025
Last updated
09/30/2025
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