Organization
METRO DETROIT KIDNEY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAYNA S NAGRECHA M.D. (OWNER)
(586) 585-9727
Entity
Organization
Contact information
Practice address
23995 GREATER MACK AVE, SUITE 102, SAINT CLAIR SHORES, MI 48080-1417
(586) 585-9727
(586) 933-2353
Mailing address
1292 EDMUNDTON DR, GROSSE POINTE WOODS, MI 48236-1027
(313) 417-3876
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
4301076247
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11-0502230-2
BCBS PIN
MI
01
—
151185
GREAT LAKES HEALTH PLAN PIN
MI
01
—
7658683
AETNA PIN
MI
Enumeration date
08/27/2009
Last updated
01/16/2014
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