Provider Demographics
NPI:1972800704
Name:NORTHCROSS NEPHROLOGY AND HYPERTENSION,PLLC
Entity Type:Organization
Organization Name:NORTHCROSS NEPHROLOGY AND HYPERTENSION,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:I
Authorized Official - Last Name:KALDAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-895-3415
Mailing Address - Street 1:19116 CYPRESS GARDEN DR
Mailing Address - Street 2:
Mailing Address - City:DAVIDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28036-8617
Mailing Address - Country:US
Mailing Address - Phone:704-895-3415
Mailing Address - Fax:
Practice Address - Street 1:19116 CYPRESS GARDEN DR
Practice Address - Street 2:
Practice Address - City:DAVIDSON
Practice Address - State:NC
Practice Address - Zip Code:28036-8617
Practice Address - Country:US
Practice Address - Phone:704-895-3415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2010-01177207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2076428Medicare PIN
G94847Medicare UPIN