Organization
NORTH GEORGIA KIDNEY SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANOLO S GALLEGO M.D. (PRESIDENT/PHYSICIAN)
(770) 528-9788
Entity
Organization
Contact information
Practice address
880 CANTON RD NE, SUITE 400, MARIETTA, GA 30060-7283
(770) 528-9788
(770) 420-2229
Mailing address
880 CANTON RD NE, SUITE 400, MARIETTA, GA 30060-7283
(770) 528-9788
(770) 420-2229
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
036745
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000960726F
—
GA
05
—
00691182AB
—
GA
01
—
1275520793
GALLEGO INDIVIDUAL NPI
GA
01
—
1285688283
MUHAMMAD YASSER JABRI, M.D. INDIVIDUAL NPI #
GA
05
—
233167541A
—
GA
05
—
282117409A
—
GA
05
—
555189352A
—
GA
01
—
DD6106
MEDICARE RAILROAD GROUP #
GA
Enumeration date
09/14/2006
Last updated
07/15/2013
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