Provider Demographics
NPI:1154411437
Name:NORTH ATLANTA NEPHROLOGY LLC
Entity type:Organization
Organization Name:NORTH ATLANTA NEPHROLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:NAJAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SABREEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-720-2423
Mailing Address - Street 1:PO BOX 2815
Mailing Address - Street 2:
Mailing Address - City:BLUE RIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30513-0050
Mailing Address - Country:US
Mailing Address - Phone:770-720-2423
Mailing Address - Fax:877-430-2887
Practice Address - Street 1:219 RIVERSTONE DR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-5256
Practice Address - Country:US
Practice Address - Phone:770-720-2423
Practice Address - Fax:877-430-2887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-15
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA053602207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA052767088AMedicaid
GA052767088AMedicaid
GAG29633Medicare UPIN