Healthcare Provider Details

I. General information

NPI: 1831300045
Provider Name (Legal Business Name): RENAL MEDICINE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2007
Last Update Date: 07/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 WARRENSVILLE CENTER RD SUITE 210
WARRENSVILLE HEIGHTS OH
44122-7051
US

IV. Provider business mailing address

PO BOX 74376
CLEVELAND OH
44194-0002
US

V. Phone/Fax

Practice location:
  • Phone: 216-491-7205
  • Fax: 216-491-7206
Mailing address:
  • Phone: 216-491-7205
  • Fax: 216-491-7206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number35-062526
License Number StateOH

VIII. Authorized Official

Name: DR. SATNAM SANDHU
Title or Position: OWNER
Credential:
Phone: 440-346-4427