| NPI | 1154361616 |
|---|---|
| Doing Business As | ST. CLAIR NEPHROLOGY, IDAHO NEPHROLOGY ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER ROBERT PROVENZANO CEO/Managing Employee (W2) 586-286-7800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2022-10-17 |