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Organization

SOUTH ATLANTA KIDNEY CARE DIALYSIS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WAINDEL BELIZAIRE D.O (PHYSICIAN-MEDICAL DIRECTOR)
(770) 994-0171
Entity
Organization

Contact information

Practice address
2221 PEACHTREE RD NE, SUITE D 195, ATLANTA, GA 30309-1148
(770) 994-0171
(770) 507-4190
Mailing address
195 UPPER RIVERDALE RD SUITE A, RIVERDALE, GA 30274
(770) 994-0171
(770) 507-4190

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
052252
GA
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
112780
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
626468445A
GA
Enumeration date
07/16/2006
Last updated
07/13/2008
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