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General NPI Number Information
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NPI Number | 1407588205
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Entity Type | Organization
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Legal Business Name | NEPHROLOGY GROUP CONSULTANTS
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Dates
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Enumeration Date | 06/29/2022
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 2012 OCILLA RD
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City | DOUGLAS
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State | GA
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Zip | 31533-2230
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Country | US
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Telephone | 912-384-7210
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Fax | 912-384-5130
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Provider Business Mailing Address
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Address Line | 1001 WARD ST W
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City | DOUGLAS
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State | GA
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Zip | 31533-2263
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | THET N ZAW
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Credential | MD
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Telephone | 912-209-4600
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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 |
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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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