Basic Information
| Provider Information | |||||||||
| NPI: | 1851348304 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KIDNEY ASSOCIATES, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 661 S TRIMBLE RD | ||||||||
| Address2: | |||||||||
| City: | MANSFIELD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 449063437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4197740478 | ||||||||
| FaxNumber: | 4197749887 | ||||||||
| Practice Location | |||||||||
| Address1: | 661 S. TRIMBLE ROAD | ||||||||
| Address2: | |||||||||
| City: | MANSFIELD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 449063437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4197740478 | ||||||||
| FaxNumber: | 4197749887 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | KAMADANA | ||||||||
| AuthorizedOfficialFirstName: | MOHAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | DOCTOR | ||||||||
| AuthorizedOfficialTelephone: | 4197740478 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D, | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.