Provider Demographics
NPI:1982786349
Name:CHILDRENS KIDNEY CENTER
Entity Type:Organization
Organization Name:CHILDRENS KIDNEY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIUS
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERWINTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-394-2358
Mailing Address - Street 1:5501 CHAMBLEE DUNWOODY RD
Mailing Address - Street 2:
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338
Mailing Address - Country:US
Mailing Address - Phone:770-394-2358
Mailing Address - Fax:770-394-3055
Practice Address - Street 1:5501 CHAMBLEE DUNWOODY RD
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338
Practice Address - Country:US
Practice Address - Phone:770-394-2358
Practice Address - Fax:770-394-3055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric NephrologyGroup - Single Specialty