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General NPI Number Information
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NPI Number | 1134899784
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Entity Type | Organization
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Legal Business Name | ATLANTIC RENAL CARE LLC
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Dates
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Enumeration Date | 09/15/2021
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Last Update Date | 09/15/2021
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Provider Practice Location Address
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Address Line | 606 S SCHUMAKER DR
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City | SALISBURY
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State | MD
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Zip | 21804-8708
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Country | US
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Telephone | 757-710-2240
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Fax |
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Provider Business Mailing Address
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Address Line | 27659 ARABIAN DR
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City | SALISBURY
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State | MD
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Zip | 21801-1830
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Country | US
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Telephone | 757-710-2240
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | NELDA BASUEL
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Credential |
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Telephone | 757-710-2240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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