Provider Demographics
NPI:1538490628
Name:M A UDDIN MD LLC
Entity Type:Organization
Organization Name:M A UDDIN MD LLC
Other - Org Name:ADVANCED NEPHROLOGY AND HYPERTENSION CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:UDDIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-334-1490
Mailing Address - Street 1:7650 S MCCLINTOCK DR STE 103-164
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-1672
Mailing Address - Country:US
Mailing Address - Phone:480-334-1490
Mailing Address - Fax:
Practice Address - Street 1:10238 E HAMPTON AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-3316
Practice Address - Country:US
Practice Address - Phone:480-553-9277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-29
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty