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General NPI Number Information
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NPI Number | 1215190996
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Entity Type | Organization
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Legal Business Name | CHATTANOOGA KIDNEY CENTERS OF NORTH LLC
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Dates
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Enumeration Date | 07/03/2008
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Last Update Date | 07/03/2008
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Provider Practice Location Address
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Address Line | 649 MORRISON SPRINGS RD
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City | CHATTANOOGA
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State | TN
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Zip | 37405
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Country | US
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Telephone | 423-648-4900
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Fax | 423-648-1868
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Provider Business Mailing Address
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Address Line | 2118 STEIN DR
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City | CHATTANOOGA
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State | TN
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Zip | 37421
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Country | US
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Telephone | 423-648-4900
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Fax | 423-648-1868
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. ADEL N SHENOUDA
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Credential | MD
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Telephone | 423-648-4900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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