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General NPI Number Information
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NPI Number | 1447664289
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Entity Type | Organization
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Legal Business Name | WAYNE KIDNEY SPECIALIST PLC
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Dates
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Enumeration Date | 06/19/2014
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Last Update Date | 10/24/2014
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Provider Practice Location Address
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Address Line | 20280 MIDDLEBELT RD
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City | LIVONIA
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State | MI
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Zip | 48152-2002
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Country | US
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Telephone | 248-987-1270
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Fax |
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Provider Business Mailing Address
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Address Line | 20280 MIDDLEBELT RD
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City | LIVONIA
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State | MI
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Zip | 48152-2002
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Country | US
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Telephone | 248-987-1270
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. NEETU SHARMA
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Credential | M.D
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Telephone | 248-987-1270
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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 |
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License Number State |
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