Provider Demographics
NPI:1003017823
Name:CHARLESTON NEPHROLOGY HYPERTENSION AND TRANSPLANT, PLLC
Entity Type:Organization
Organization Name:CHARLESTON NEPHROLOGY HYPERTENSION AND TRANSPLANT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:RAHMAN
Authorized Official - Last Name:ZANABLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-400-4700
Mailing Address - Street 1:4825 MACCORKLE AVE SW
Mailing Address - Street 2:SUITE A
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309
Mailing Address - Country:US
Mailing Address - Phone:304-400-4700
Mailing Address - Fax:304-693-2606
Practice Address - Street 1:4825 MACCORKLE AVE SW
Practice Address - Street 2:SUITE A
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309
Practice Address - Country:US
Practice Address - Phone:304-400-4700
Practice Address - Fax:304-693-2606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV22697207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001953144OtherBC BS
WV3810010603Medicaid
WVH15933Medicare UPIN
WV9369821Medicare PIN