MEDICARE: NEPHROLOGY AND HYPERTENSION MEDICAL ASSOCIATES PC

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	174400000X	Specialist	7157	SC

General Provider Information

NPI Number	:	1184955791
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEPHROLOGY AND HYPERTENSION MEDICAL ASSOCIATES PC

Provider Business Mailing Address
First Line	:	P.O. BOX 15238
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31416-1938
Country	:	US
Telephone Number	:	912-354-4813
Fax Number	:	912-354-7569

Provider Business Practice Location Address
First Line	:	16 OKATIE CTR BLVD STE 100
Second Line	:
City	:	OKATIE
State	:	SC
Zip	:	29909-7533
Country	:	US
Telephone Number	:	912-354-4813
Fax Number	:	912-354-7569

Authorized Official
Title or Position	:	PHYSICIAN/PRESIDENT
Name	:	DR. DANA A KUMJIAN
Credential	:	M.D.
Telephone Number	:	912-354-4813

Provider Enumeration Date	:	01/21/2010
Last Update Date	:	08/21/2015

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