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General NPI Number Information
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NPI Number | 1326400656
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Entity Type | Organization
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Legal Business Name | CENTER FOR KIDNEY AND METABOLIC DISORDERS PLLC
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Dates
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Enumeration Date | 03/25/2016
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Last Update Date | 12/16/2020
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Provider Practice Location Address
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Address Line | 31 STILES RD STE 2400
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City | SALEM
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State | NH
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Zip | 03079
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Country | US
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Telephone | 603-890-2771
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Fax | 603-890-2886
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Provider Business Mailing Address
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Address Line | 31 STILES RD STE 2400
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City | SALEM
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State | NH
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Zip | 03079-3037
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Country | US
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Telephone | 603-890-2771
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Fax | 603-890-2886
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANA R. STANKOVIC
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Credential | MD
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Telephone | 603-890-2771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 13080
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License Number State | NH
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