Organization
HOPE KIDNEY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIRISHA GUTHIKONDA MD (PRESIDENT)
(770) 765-3766
Entity
Organization
Contact information
Practice address
460 NORTHSIDE CHEROKEE BLVD STE 430, CANTON, GA 30115-8020
(770) 765-3766
Mailing address
12460 CRABAPPLE RD # 202-158, ALPHARETTA, GA 30004-6602
(770) 765-3766
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
80747
LICENSE
GA
Enumeration date
01/06/2021
Last updated
01/06/2021
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