Provider Demographics
NPI:1447612874
Name:ASSOCIATED NEPHROLOGY OF NORTHEAST GEORGIA LLC
Entity Type:Organization
Organization Name:ASSOCIATED NEPHROLOGY OF NORTHEAST GEORGIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NUZHAT
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-434-2753
Mailing Address - Street 1:641 HOSPITAL RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:COMMERCE
Mailing Address - State:GA
Mailing Address - Zip Code:30529-1155
Mailing Address - Country:US
Mailing Address - Phone:706-335-4212
Mailing Address - Fax:706-336-8142
Practice Address - Street 1:641 HOSPITAL RD
Practice Address - Street 2:SUITE 2
Practice Address - City:COMMERCE
Practice Address - State:GA
Practice Address - Zip Code:30529-1155
Practice Address - Country:US
Practice Address - Phone:706-335-4212
Practice Address - Fax:706-336-8142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-24
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty