Provider Demographics
NPI:1962486316
Name:RENAL PHYSICIANS INC
Entity Type:Organization
Organization Name:RENAL PHYSICIANS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:AUGUSTUS
Authorized Official - Middle Name:K
Authorized Official - Last Name:EDUAFO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-222-3118
Mailing Address - Street 1:500 LINCOLN PARK BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-6410
Mailing Address - Country:US
Mailing Address - Phone:937-222-3118
Mailing Address - Fax:937-222-1436
Practice Address - Street 1:500 LINCOLN PARK BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-6410
Practice Address - Country:US
Practice Address - Phone:937-222-3118
Practice Address - Fax:937-222-1436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-30
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0315108Medicaid
OH0315108Medicaid
OH9911982Medicare PIN
OH9911985Medicare PIN
OH9911983Medicare PIN
OH9911988Medicare PIN
OH9911984Medicare PIN
OH9911981Medicare PIN