Provider Demographics
NPI:1487216958
Name:EPIC KIDNEY CENTER PC
Entity Type:Organization
Organization Name:EPIC KIDNEY CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VISHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:PAREKH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-316-8645
Mailing Address - Street 1:960 SANDERS RD STE 700
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6058
Mailing Address - Country:US
Mailing Address - Phone:678-272-3777
Mailing Address - Fax:
Practice Address - Street 1:960 SANDERS RD STE 700
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-6058
Practice Address - Country:US
Practice Address - Phone:678-272-3777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-03
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty