PRINCE GEORGE'S KIDNEY CARE, LLC (NPI# 1144855024) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144855024 |
| Entity Type | Organization |
| Organization Name | PRINCE GEORGE'S KIDNEY CARE, LLC |
| Practice Address |
12200 Annapolis Rd Ste 233 Glenn Dale MD 20769-9182 |
| Mailing Address |
8400 Rainbow Rd Vienna VA 22182-3727 |
| Practice Telephone | 3013655809 |
| Practice Fax Number | 3013655813 |
| Mailing Telephone | 3015093018 |
| Enumeration Date | 2020-03-11 |
| Last Update Date | 2020-03-11 |
| Authorized Official Name | DR. BABAK RAZI (OWNER) |
| Authorized Official Telephone | 3015093018 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
| Street Address |
12200 ANNAPOLIS RD STE 233 |
| City | GLENN DALE |
| State | MD |
| Zip Code | 20769-9182 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023585676 | Ifeoma C Onyeiwu | Nurse Practitioner | Krystal Medical Associates, 12150 Annapolis Rd, Suite 100, Glenndale, MD 20769 | 2018-10-31 |
| 1124593983 | Olivia Kaindaneh | Technician | 10809 Glandshire Dr, Glandale, MD 20769 | 2018-10-09 |
| 1154810505 | Cassie Leghu | Home Health Aide | 5108 Janesdale Court, Glenn Dale, MD 20769 | 2018-05-01 |
| 1033659164 | Eternal Dermatology and Aesthetic Center LLC | Dermatology | 12150 Annapolis Rd Ste 213, Glenn Dale, MD 20769 | 2017-03-08 |
| 1881957934 | Angela Teresa Dudley Hamilton | Counselor | 11415 Old Pond Drive, Glenn Dale, MD 20769 | 2012-06-22 |
| 1144597923 | Jaj Health Care Services,llc | Clinical Nurse Specialist | 12150 Annapolis Rd # 205, Glenndale, MD 20769 | 2011-11-22 |
| 1831493030 | Evidence Physical Therapy, LLC | Physical Therapist | 12150 Annapolis Rd Ste 201, Glenn Dale, MD 20769 | 2011-01-03 |
| 1972731867 | Linh Nguyen | Pharmacist | 10831 Lanham Severn Rd, Glenn Dale, MD 20769 | 2009-06-30 |
| 1417141557 | Sharon Evette Hawks | Nutritionist | 12150 Annapolis Rd., Ste. 104, Glenn Dale, MD 20769 | 2007-08-31 |
| 1871715441 | Beth S Warner | Psychologist | 1107 Shoemaker Bldg., U. of Md Counseling Center, Glenn Dale, MD 20769 | 2007-05-03 |
| Find all providers in zip 20769 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093294910 | Metropolitan Vascular Institute LLC | Internal Medicine | 12070 Old Line Ctr Ste 100, Waldorf, MD 20602 | 2018-08-10 |
| 1801391933 | Southern Maryland Nephrology and Hypertension | Internal Medicine | 9131 Piscataway Rd Ste 750, Clinton, MD 20735-2581 | 2018-03-29 |
| 1649724931 | Howard A. Austin IIi | Internal Medicine | National Institutes of Health Nih, Crc Bldg. 10/room 5-2551, Bethesda, MD 20892-0001 | 2016-08-04 |
| 1700269230 | Mohammadali Anwar | Internal Medicine | 4475 Regency Pl Ste 201, White Plains, MD 20695-3074 | 2015-07-01 |
| 1467834556 | Neeharik Mareedu | Internal Medicine | 12502 Willowbrook Rd Ste 400, Cumberland, MD 21502-6567 | 2015-06-24 |
| 1285031765 | Hossam Abdalla | Internal Medicine | 25 Crossroads Dr Ste 205, Owings Mills, MD 21117-5533 | 2014-11-26 |
| 1780094219 | Harshal P Shah | Internal Medicine | 8926 Woodyard Rd Ste 602, Clinton, MD 20735-4235 | 2014-05-06 |
| 1346683935 | Kryt Chattrabhuti | Internal Medicine | 116 Defense Hwy Ste 202, Annapolis, MD 21401-7045 | 2013-04-12 |
| 1962744268 | Mohamad Hanouneh | Internal Medicine | 5601 Loch Raven Blvd Ste 3n, Baltimore, MD 21239 | 2013-03-25 |
| 1699012575 | Ramnika Iqbal Singh Gumber | Internal Medicine | 1830 E. Monument Street, 4th Floor, Suite 416, Baltimore, MD 21287 | 2013-01-11 |
| Find all providers with the same taxonomy | ||||
| City | GLENN DALE |
| Zip Code | 20769 |
Please comment or provide details below to improve the information on PRINCE GEORGE'S KIDNEY CARE, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.