MEDICARE: ALBEMARLE NEPHROLOGY ASSOC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician

General Provider Information

NPI Number	:	1669467767
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALBEMARLE NEPHROLOGY ASSOC

Provider Business Mailing Address
First Line	:	206 HASTINGS LN
Second Line	:
City	:	ELIZABETH CITY
State	:	NC
Zip	:	27909-3324
Country	:	US
Telephone Number	:	252-335-1083
Fax Number	:	252-335-4030

Provider Business Practice Location Address
First Line	:	206 HASTINGS LN
Second Line	:
City	:	ELIZABETH CITY
State	:	NC
Zip	:	27909-3324
Country	:	US
Telephone Number	:	252-335-1083
Fax Number	:	252-335-4030

Authorized Official
Title or Position	:	OWNER
Name	:	KARL BRANDSPIGEL
Credential	:	MD
Telephone Number	:	252-335-1083

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	06/12/2008

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