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General NPI Number Information
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NPI Number | 1538138185
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Entity Type | Organization
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Legal Business Name | MARYLAND NEPHROLOGY CLINIC LLC
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 2000 W BALTIMORE ST FL 3
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City | BALTIMORE
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State | MD
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Zip | 21223-1558
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Country | US
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Telephone | 410-362-3400
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Fax | 410-720-2545
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Provider Business Mailing Address
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Address Line | 4310 ENGLISH MORNING LN
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City | ELLICOTT CITY
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State | MD
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Zip | 21043-6790
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Country | US
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Telephone | 410-418-8740
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Fax | 410-418-8740
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KULWANT SINGH MODI
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Credential | MD, FRCP,FACP,FASN
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Telephone | 410-418-8740
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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 | D0059917
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License Number State | MD
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