Organization
SOUTHERN NEPHROLOGY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAFIQ M EL HAMMALI M.D. (OWNER/MANAGER)
(770) 577-4825
Entity
Organization
Contact information
Practice address
8954 HOSPITAL DR, BUILDING C. SUITE 115, DOUGLASVILLE, GA 30134-2272
(770) 577-4825
(770) 577-4827
Mailing address
PO BOX 385, DOUGLASVILLE, GA 30133-0385
(770) 577-4825
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
057606
GA
Other
Enumeration date
08/07/2007
Last updated
04/07/2009
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