Organization
THE KIDNEY GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHANIEL S DOE MD (PRESIDENT)
(330) 746-1488
Entity
Organization
Contact information
Practice address
1340 BELMONT AVE, SUITE 2300, YOUNGSTOWN, OH 44504-1125
(330) 746-1488
(330) 746-0384
Mailing address
1340 BELMONT AVE, SUITE 2300, YOUNGSTOWN, OH 44504-1125
(330) 746-1488
(330) 746-0384
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
952644
OH
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009994970002
—
PA
05
—
0630213
—
OH
01
—
099187
HIGHMARK
OH
01
—
1502089
GATEWAY
PA
01
—
202550
UPMC
PA
01
—
824865
HIGHMARK
PA
Enumeration date
01/31/2007
Last updated
09/18/2020
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