Provider Demographics
NPI:1164823894
Name:BRADLEY NEPHROLOGY
Entity Type:Organization
Organization Name:BRADLEY NEPHROLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BALRAM
Authorized Official - Middle Name:L
Authorized Official - Last Name:CHHAJWANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-339-3340
Mailing Address - Street 1:915 CLINGAN RIDGE DR NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-3729
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:915 CLINGAN RIDGE DR NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-3729
Practice Address - Country:US
Practice Address - Phone:423-339-3340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BALRAM L. CHHAJWANI
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-09-12
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18795207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty