| NPI | 1891978953 |
|---|---|
| Other Name | DIVERSIFIED RENAL GROUP FAYETTE, PLLC |
| Entity Type | Organization |
| Authorized Contact | TUNDE OLUTADE Member 601-899-3340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2008-01-15 |