THE KIDNEY CLINIC NPI 1811159718

NPI Information

  • NPI: 1811159718
  • Provider Name: THE KIDNEY CLINIC
  • Classification: Clinic/Center - 261QM2500X
  • Specialization: Medical Specialty
  • Entity Type: Organization
  • Address: 2386 CLOWER ST STE C105
    SNELLVILLE, GA
    ZIP 30078
  • Phone: (678) 344-0334

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NPI Details

THE KIDNEY CLINIC is a medical specialty clinic center in Snellville, GA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). THE KIDNEY CLINIC NPI is 1811159718. The provider is registered as an organization entity type.

The provider's business location address is:

2386 CLOWER ST STE C105
SNELLVILLE, GA
ZIP 30078-107
Phone: (678) 344-0334
Fax: (678) 344-0343

The provider's authorized official is Mazen A Abdalla .
The authorized official title is Physician and has the following contact phone number (678) 344-0334.

The enumeration date for this NPI number is 7/1/2008 and was last updated on 9/11/2025.

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
1261QM2500XClinic/CenterMedical Specialty038414GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11467420893OTHERGEORGIANPI FOR MAZEN ABDALLA,MD
200612752AMEDICAIDGEORGIA

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: 11/21/2025

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