MEDICARE: KIDNEY DISEASE & HYPERTENSION, P.C.

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	4301075209	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1102512741	OTHER	MI	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982701256
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIDNEY DISEASE & HYPERTENSION, P.C.

Provider Business Mailing Address
First Line	:	2387 S LINDEN RD STE A
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48532-5443
Country	:	US
Telephone Number	:	810-733-1700
Fax Number	:	810-733-1701

Provider Business Practice Location Address
First Line	:	2387 S LINDEN RD STE A
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48532-5443
Country	:	US
Telephone Number	:	810-733-1700
Fax Number	:	810-733-1701

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	ALI K OWDA
Credential	:	M.D.
Telephone Number	:	810-733-1700

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	08/25/2025

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Directions to “KIDNEY DISEASE & HYPERTENSION, P.C. ” Practice Location

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