Organization
GEORGIA KIDNEY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RIYADH R AL-RUBAYE MD (OWNER)
(047) 316-0334
Entity
Organization
Contact information
Practice address
3382 GRACE FARM LN, BUFORD, GA 30519
(404) 731-6033
Mailing address
2725 HAMILTON MILL RD STE 500, BUFORD, GA 30519-6010
(404) 731-6033
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
—
—
Other
Enumeration date
10/28/2022
Last updated
10/28/2022
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