Organization
WASHINGTON DIALYSIS CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUBRAMONIAM JAYAKUMAR MD (OWNER, C.E.O)
(724) 229-7377
Entity
Organization
Contact information
Practice address
764 LOCUST AVE, WASHINGTON, PA 15301-2756
(724) 229-7377
(724) 228-1513
Mailing address
764 LOCUST AVE, WASHINGTON, PA 15301-2756
(724) 229-7377
(724) 228-1513
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
MD035880L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127527
—
PA
01
—
MD035880L
MEDICAL LICENSE
PA
Enumeration date
01/16/2008
Last updated
03/07/2023
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