Provider Demographics
NPI:1952632838
Name:ADVANCED KIDNEY CARE INC
Entity Type:Organization
Organization Name:ADVANCED KIDNEY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEPHROLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSHAUDDIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FASN
Authorized Official - Phone:301-789-5381
Mailing Address - Street 1:6341 DUNN CT
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-7840
Mailing Address - Country:US
Mailing Address - Phone:301-789-5381
Mailing Address - Fax:
Practice Address - Street 1:6357 OXON HILL RD
Practice Address - Street 2:SUITE:100
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-2214
Practice Address - Country:US
Practice Address - Phone:301-220-0435
Practice Address - Fax:301-220-0412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-16
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD68186207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty