Organization
KIDNEY ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN MEDENILLA ZUNIGA MD (OWNER)
(304) 767-7920
Entity
Organization
Contact information
Practice address
8152-B COURT AVENUE, HAMLIN, WV 25523
(304) 824-7980
(304) 824-7982
Mailing address
4607 MACCORKLE AVE SW, SUITE 206, SOUTH CHARLESTON, WV 25309-1364
(304) 767-7920
(304) 767-7925
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9326121
MEDICARE GROUP NUMBER
—
Enumeration date
03/03/2008
Last updated
03/03/2008
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