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General NPI Number Information
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NPI Number | 1679673701
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Entity Type | Organization
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Legal Business Name | CENTRAL MARYLAND NEPHROLOGY, LLC
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 04/09/2013
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Provider Practice Location Address
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Address Line | 7331 HANOVER PKWY SUITE B
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City | GREENBELT
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State | MD
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Zip | 20770-3621
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Country | US
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Telephone | 301-345-0605
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Fax | 301-345-0606
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Provider Business Mailing Address
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Address Line | 7331 HANOVER PKWY SUITE B
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City | GREENBELT
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State | MD
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Zip | 20770-3621
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Country | US
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Telephone | 301-345-0605
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Fax | 301-345-0606
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ALI IPAKCHI
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Credential | MD
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Telephone | 301-345-0605
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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 |
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License Number State |
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