Provider Demographics
NPI:1275870123
Name:GADSDEN NEPHROLOGY LLC
Entity Type:Organization
Organization Name:GADSDEN NEPHROLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLING OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:HUMAYUN
Authorized Official - Last Name:KABIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-916-1103
Mailing Address - Street 1:104 LOWES BLVD
Mailing Address - Street 2:
Mailing Address - City:RAINBOW CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35906-3132
Mailing Address - Country:US
Mailing Address - Phone:816-916-1103
Mailing Address - Fax:
Practice Address - Street 1:425 S 3RD ST
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-5210
Practice Address - Country:US
Practice Address - Phone:256-543-3508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-12
Last Update Date:2013-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.29441207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty