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General NPI Number Information
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NPI Number | 1699934711
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Entity Type | Organization
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Legal Business Name | KIDNEY CENTER PLLC
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Dates
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Enumeration Date | 06/04/2008
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Last Update Date | 06/04/2009
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Provider Practice Location Address
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Address Line | 1751 WEST MORRIS BLVD. SUITE 4
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City | MORRISTOWN
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State | TN
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Zip | 37813
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Country | US
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Telephone | 423-307-8951
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Fax | 423-307-8978
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Provider Business Mailing Address
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Address Line | 1751 WEST MORRIS BLVD SUITE 4
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City | MORRISTOWN
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State | TN
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Zip | 37813
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Country | US
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Telephone | 423-307-8951
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Fax | 423-307-8978
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Authorized Official
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Title or Position | MD
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Name | DR. MOHAMMED I AHMED
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Credential | MD
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Telephone | 423-307-8951
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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 | MD35880
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License Number State | TN
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