MID-ATLANTIC NEPHROLOGY ASSOCIATES PA - NPI 1407605389 - Internal Medicine in Glen Burnie, MD

Q: What is Mid-Atlantic Nephrology Associates PA's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

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About Mid-atlantic Nephrology Associates Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MID-ATLANTIC NEPHROLOGY ASSOCIATES PA (NPI 1407605389) is a healthcare organization registered as a nephrology in Glen Burnie, Maryland and active in the NPI registry since May 2024. The organization holds a CLIA Microscopy certificate valid through June 18, 2028 and lists Robert Fuld, President/ceo, as its authorized official.

NPPES Registry Identity

NPI1407605389

Entity TypeOrganization

Primary Taxonomy207RN0300X

Legal Business NameMID-ATLANTIC NEPHROLOGY ASSOCIATES PA

Location Address6934 AVIATION BLVD STE FGlen Burnie, MD 21061-2593

Mailing Address1589 Sulphur Spring Rd Ste 109Baltimore, MD 21227-2542 · (410) 536-5400 · Fax (410) 737-2168

Phone(410) 760-3588

Fax(410) 760-3604

Organization SubpartNo

Authorized OfficialRobert FuldPresident/ceo · (410) 536-5400

Enumeration DateMay 14, 2024

Last NPPES UpdateFebruary 12, 2026

NPPES CertifiedFebruary 12, 2026

✔ NPI 1407605389 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

Definition

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.

6934 AVIATION BLVD STE F, Glen Burnie, MD 21061

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 21D0916296

Mid-Atlantic Nephrology Assoc PA · Glen Burnie, MD

Active · expires Jun 18, 2028

CLIA Number21D0916296

Laboratory TypePhysician Office

Certificate Effective DateJune 19, 2026

Certificate Expiration DateJune 18, 2028

Laboratory DirectorShahab A. Khan

Laboratory Phone(410) 760-3588

Laboratory LocationMid-Atlantic Nephrology Assoc PA6934 Aviation Blvd Suite F, Glen Burnie, MD 21061

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANURADHA BODDETI M.D.

Internal Medicine (Nephrology)