Organization
NEPHROLOGY & HYPERTENSION MEDICAL ASSOCIATES, PC
Active
Other names
Nephrology and Endocrinolgy Consultants
Organization subpart
No
Provider details
NPI number
Authorized official
TRISH G ROTUREAU (OPERATION MANAGER)
(912) 650-5450
Entity
Organization
Contact information
Practice address
111 COLONIAL WAY STE 2, JESUP, GA 31545-0132
(912) 588-1919
(912) 354-7569
Mailing address
208 SCRANTON CONNECTOR, SUITE 117, BRUNSWICK, GA 31525-0559
(912) 264-5961
(912) 262-9499
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
026402
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000291079A
—
GA
05
—
000291079K
—
GA
05
—
000291079M
—
GA
05
—
000291079O
—
GA
05
—
000291079Q
—
GA
05
—
000291079Z
—
GA
05
—
630423104A
—
GA
05
—
630423104C
—
GA
01
—
GRP2930
MEDICARE GROUP
GA
Enumeration date
11/08/2006
Last updated
05/02/2019
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