Organization
KIDNEY HYPERTENSION CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRTI K SHAH M.D. (PRESIDENT)
(770) 962-1231
Entity
Organization
Contact information
Practice address
605 OLD NORCROSS RD, LAWRENCEVILLE, GA 30045-4315
(770) 962-1231
Mailing address
605 OLD NORCROSS RD, LAWRENCEVILLE, GA 30045-4315
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG3048
RAILROAD MEDICARE
GA
Enumeration date
08/23/2006
Last updated
11/15/2007
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