Provider Demographics
NPI:1730269119
Name:N E ALABAMA NEPHROLOGY LLC
Entity type:Organization
Organization Name:N E ALABAMA NEPHROLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:F
Authorized Official - Last Name:HWANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-543-3508
Mailing Address - Street 1:425 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-5210
Mailing Address - Country:US
Mailing Address - Phone:256-543-3508
Mailing Address - Fax:
Practice Address - Street 1:425 S 3RD ST
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-5210
Practice Address - Country:US
Practice Address - Phone:256-543-3508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL18372174400000X
AL21162174400000X
AL7691174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009916955Medicaid
ALJ268OtherGROUP
AL009917005Medicaid
AL009916975Medicaid
AL009916955Medicaid
ALG64383Medicare UPIN
AL051553096Medicare ID - Type Unspecified
AL051553097Medicare ID - Type Unspecified
AL051553095Medicare ID - Type Unspecified
AL009917005Medicaid