Provider Demographics
NPI:1992891014
Name:NEPHROLOGY ASSOCIATES OF SOUTHWESTERN OHIO, INC.
Entity type:Organization
Organization Name:NEPHROLOGY ASSOCIATES OF SOUTHWESTERN OHIO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BHUPENDRA
Authorized Official - Middle Name:H
Authorized Official - Last Name:MAHIDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-863-8212
Mailing Address - Street 1:3090 MCBRIDE CT
Mailing Address - Street 2:SUITE B
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-0811
Mailing Address - Country:US
Mailing Address - Phone:513-863-8212
Mailing Address - Fax:513-863-8379
Practice Address - Street 1:2960 MACK RD
Practice Address - Street 2:#203
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-5373
Practice Address - Country:US
Practice Address - Phone:513-863-8212
Practice Address - Fax:513-863-8379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2288215Medicaid
OH2288215Medicaid