Provider Demographics
NPI:1417068693
Name:HYPERTENSION NEPHROLOGY ASSOCIATES PC
Entity Type:Organization
Organization Name:HYPERTENSION NEPHROLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:MARRONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-478-1500
Mailing Address - Street 1:PO BOX 67000
Mailing Address - Street 2:DEPT 06301
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48267-0063
Mailing Address - Country:US
Mailing Address - Phone:248-478-1500
Mailing Address - Fax:248-478-2798
Practice Address - Street 1:18302 MIDDLEBELT ROAD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-5007
Practice Address - Country:US
Practice Address - Phone:248-478-1500
Practice Address - Fax:248-478-2798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M70370Medicare PIN