Provider Demographics
NPI:1851553713
Name:NORTH ATLANTA NEPHROLOGY HYPERTENTION LLC
Entity Type:Organization
Organization Name:NORTH ATLANTA NEPHROLOGY HYPERTENTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHOB
Authorized Official - Middle Name:
Authorized Official - Last Name:AAMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-569-2727
Mailing Address - Street 1:11795 NORTHFALL LANE
Mailing Address - Street 2:SUITE# 602
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-7968
Mailing Address - Country:US
Mailing Address - Phone:770-569-2727
Mailing Address - Fax:770-569-4131
Practice Address - Street 1:11795 NORTHFALL LANE
Practice Address - Street 2:SUITE# 602
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-7968
Practice Address - Country:US
Practice Address - Phone:770-569-2727
Practice Address - Fax:770-569-4131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA38158174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00708485EMedicaid
GA39BDCBPOtherMEDICARE ID
GA39BDCBPOtherMEDICARE ID