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General NPI Number Information
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NPI Number | 1376829671
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Entity Type | Organization
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Legal Business Name | KIDNEY SPECIALISTS, PLLC
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Dates
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Enumeration Date | 10/31/2011
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Last Update Date | 01/09/2012
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Provider Practice Location Address
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Address Line | 176 HEALTH CARE LN STE A
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City | MARTINSBURG
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State | WV
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Zip | 25401-4010
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Country | US
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Telephone | 304-262-4123
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Fax | 304-262-0356
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Provider Business Mailing Address
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Address Line | 176 HEALTH CARE LN STE A
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City | MARTINSBURG
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State | WV
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Zip | 25401-4010
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Country | US
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Telephone | 304-262-4123
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Fax | 304-262-0356
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Authorized Official
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Title or Position | OWNER
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Name | DR. BABAK BARMAR
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Credential | MD
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Telephone | 412-657-0269
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 24463
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License Number State | WV
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