Provider Demographics
NPI:1427238773
Name:NEPHROLOGY &INTERNAL MEDICINE OF GREATER WASHINGTON PC
Entity type:Organization
Organization Name:NEPHROLOGY &INTERNAL MEDICINE OF GREATER WASHINGTON PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANDRASEKHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:KORAPATI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-474-4443
Mailing Address - Street 1:PO BOX 835
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20768-0835
Mailing Address - Country:US
Mailing Address - Phone:301-474-4443
Mailing Address - Fax:301-474-1154
Practice Address - Street 1:9804 JUNIPER HILL RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-5421
Practice Address - Country:US
Practice Address - Phone:240-499-8153
Practice Address - Fax:240-499-8548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCCS9509247282N00000X
MDM44451282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCG01112Medicare PIN