Organization
KIDNEY DISEASE AND HYPERTENSION SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAYYAZ H SAGARWALA MD (MEMBER)
(573) 785-5444
Entity
Organization
Contact information
Practice address
2620 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3396
(573) 785-7721
Mailing address
2628 BARRON RD, POPLAR BLUFF, MO 63901-1916
(573) 785-5444
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
2006018918
MO
Other
Enumeration date
12/16/2008
Last updated
12/16/2008
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