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NPI Code Detail

MEDICARE: RENAL ASSOCIATES OF ROANOKE, LLC

MEDICARE: RENAL ASSOCIATES OF ROANOKE, LLC
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
1207RN0300XNephrology Physician

General Provider Information

NPI Number : 1447017314
Entity Type Code : Organization
Provider Name (Legal Business Name) : RENAL ASSOCIATES OF ROANOKE, LLC
Provider Business Mailing Address
First Line : 6228 BRADLEY PARK DR STE A
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-3605
Country : US
Telephone Number : 706-322-1486
Fax Number : 706-324-3419
Provider Business Practice Location Address
First Line : 4459 HIGHWAY 431
Second Line :
City : ROANOKE
State : AL
Zip : 36274-2603
Country : US
Telephone Number : 706-322-1486
Fax Number : 706-324-3419
Authorized Official
Title or Position : OWNER
Name : RAJEEV CHAUHAN
Credential : MD
Telephone Number : 706-322-1486
Provider Enumeration Date : 03/06/2024
Last Update Date : 03/06/2024

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Directions to “RENAL ASSOCIATES OF ROANOKE, LLC ” Practice Location

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