Provider Demographics
NPI:1851348304
Name:KIDNEY ASSOCIATES, INC.
Entity Type:Organization
Organization Name:KIDNEY ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:MOHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMADANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:419-774-0478
Mailing Address - Street 1:661 S TRIMBLE RD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-3437
Mailing Address - Country:US
Mailing Address - Phone:419-774-0478
Mailing Address - Fax:419-774-9887
Practice Address - Street 1:661 S. TRIMBLE ROAD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-3437
Practice Address - Country:US
Practice Address - Phone:419-774-0478
Practice Address - Fax:419-774-9887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9260531Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER