Healthcare Provider Details

I. General information

NPI: 1003837337
Provider Name (Legal Business Name): NEPHROLOGY CONSULTANTS OF PINELLAS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 LAKEVIEW RD SUITE C
CLEARWATER FL
33756-3338
US

IV. Provider business mailing address

617 LAKEVIEW RD STE C
CLEARWATER FL
33756-3338
US

V. Phone/Fax

Practice location:
  • Phone: 727-441-3724
  • Fax: 727-442-2594
Mailing address:
  • Phone: 727-441-3724
  • Fax: 727-442-2594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberME0034568
License Number StateFL

VIII. Authorized Official

Name: DR. MICHAEL WILLIAM HAM
Title or Position: OWNER
Credential: MD
Phone: 727-441-3724