MEDICARE: ADVANCED KIDNEY CARE INC

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	D68186	MD

General Provider Information

NPI Number	:	1952632838
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED KIDNEY CARE INC

Provider Business Mailing Address
First Line	:	6341 DUNN CT
Second Line	:
City	:	SPRINGFIELD
State	:	VA
Zip	:	22150-7840
Country	:	US
Telephone Number	:	301-789-5381
Fax Number	:

Provider Business Practice Location Address
First Line	:	6357 OXON HILL RD
Second Line	:	SUITE:100
City	:	OXON HILL
State	:	MD
Zip	:	20745-2214
Country	:	US
Telephone Number	:	301-220-0435
Fax Number	:	301-220-0412

Authorized Official
Title or Position	:	NEPHROLOGIST
Name	:	MOHAMMED YOUSHAUDDIN
Credential	:	M.D., FASN
Telephone Number	:	301-789-5381

Provider Enumeration Date	:	01/16/2010
Last Update Date	:	04/29/2010

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Directions to “ADVANCED KIDNEY CARE INC ” Practice Location

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