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General NPI Number Information
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NPI Number | 1467544643
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Entity Type | Organization
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Legal Business Name | THE KIDNEY GROUP OF MEMPHIS, PLLC
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 2225 UNION AVE SUITE 100
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City | MEMPHIS
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State | TN
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Zip | 38104-4316
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Country | US
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Telephone | 901-726-1161
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Fax | 901-726-0161
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Provider Business Mailing Address
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Address Line | 2225 UNION AVE SUITE 100
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City | MEMPHIS
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State | TN
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Zip | 38104-4316
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Country | US
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Telephone | 901-726-1161
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Fax | 901-726-0161
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Authorized Official
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Title or Position | PRESIDENT/PARTNER
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Name | MARC H. STEGMAN
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Credential | M.D.
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Telephone | 901-726-1161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 19034
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License Number State | TN
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