| Hypertension & Kidney,pc | |
|
134 S Clayton St Suit # 8 Lawrenceville GA 30046-5753 | |
| (770) 513-3565 | |
| (770) 513-1924 |
| Full Name | Hypertension & Kidney,pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 134 S Clayton St, Lawrenceville, Georgia |
| Authorized Official Name and Position | Nabila Hussain (PRESIDENT) |
| Authorized Official Contact | 7705133565 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hypertension & Kidney,pc Po Box 1126 Lawrenceville GA 30046-1126 Ph: (770) 513-3565 | Hypertension & Kidney,pc 134 S Clayton St Suit # 8 Lawrenceville GA 30046-5753 Ph: (770) 513-3565 |
| NPI Number | 1104872647 |
|---|---|
| Provider Enumeration Date | 05/26/2006 |
| Last Update Date | 06/11/2020 |
| Medicare PECOS PAC ID | 7315936192 |
|---|---|
| Medicare Enrollment ID | O20040507000478 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104872647 | NPI | - | NPPES |
| 553623912A | Medicaid | GA | |
| 000967095E | Medicaid | GA | |
| 000967095G | Medicaid | GA | |
| 000967095C | Medicaid | GA | |
| 000967095J | Medicaid | GA | |
| 000967095K | Medicaid | GA | |
| 000967095B | Medicaid | GA | |
| 000967095H | Medicaid | GA | |
| 000967095F | Medicaid | GA | |
| 000967095I | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 051765 (Georgia) | Primary |
| 207RN0300X | Internal Medicine - Nephrology | 051765 (Georgia) | Secondary |
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