Organization
KIDNEY MEDICAL ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELANIE APRIL UNGER (CREDENTIALING REPRESENTATIVE)
(301) 638-7802
Entity
Organization
Contact information
Practice address
4475 REGENCY PL, SUITE 201, WHITE PLAINS, MD 20695-3072
(301) 638-7802
(301) 638-7805
Mailing address
4475 REGENCY PL, SUITE 201, WHITE PLAINS, MD 20695-3072
(301) 638-7802
(301) 638-7805
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010336864
—
VA
01
—
0452
BLUE CHOICE
MD
05
—
411242301
—
MD
01
—
DF9122
MEDICARE RAILROAD
—
Enumeration date
08/29/2006
Last updated
04/03/2014
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