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CARITAS MEDICAL CENTER NPI 1245390681


NPI Information

NPI: 1245390681
Provider Name: CARITAS MEDICAL CENTER
Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

CLIA Number: 11D1062792

Address:
105 N PARK TRL
STE 300
STOCKBRIDGE, GA
ZIP 30281
Phone: (678) 284-0800
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CARITAS MEDICAL CENTER is a nephrology internal medicine in Stockbridge, GA. The provider is 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. CARITAS MEDICAL CENTER NPI is 1245390681. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

105 N PARK TRL
STE 300
STOCKBRIDGE, GA
ZIP 30281-373
Phone: (678) 284-0800
Fax: (678) 284-0393

The provider's authorized official is Leo O Ovadje .
The authorized official title is Physician And Owner and has the following contact phone number (678) 284-0800.

The CLIA number assigned to this NPI record is 11D1062792 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/8/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RN0300XInternal MedicineNephrology055143GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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