Aegis Nephrology & Internal Medicine, LLC

Organization Active NPI Nephrology Physician · Warner Robins, GA

NPI 1043485352 · NPPES record last updated Nov 7, 2016

Key facts

NPI
1043485352
Entity type
Organization (NPI type 2)
Primary specialty
Nephrology Physician 207RN0300X
License
052234 (GA)
Legal business name
AEGIS NEPHROLOGY & INTERNAL MEDICINE, LLC
Practice address
130 Hospital Dr
Warner Robins, GA 31088-4204
Phone
(478) 225-9983
Fax
(478) 225-9891
NPI assigned
Apr 28, 2008
Organization subpart
No

Authorized official

Name
Navin Taneja, M.D.
Title
Owner/Physician
Phone
(478) 225-9983

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20080717000122 GA Part B Supplier - Clinic/Group Practice 9638242175 Receives reassigned benefits from 1 practitioner
Practice locations: Perry, GA; Warner Robins, GA

National Provider Directory

Locations

1118 Morningside Dr
Perry, GA 31069

130 Dr Parihar Dr
Warner Robins, GA 31088

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207R00000X 052234 GA
Geriatric Medicine (Internal Medicine) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RG0300X 052234 GA
Nephrology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RN0300X 052234 GA Yes

Addresses

Primary practice location

130 Hospital Dr
Warner Robins, GA 31088-4204

Mailing address

130 Hospital Dr
Warner Robins, GA 31088-4204
Phone (478) 225-9983

Other providers in Warner Robins, GA

All providers in Warner Robins, GA · Nephrology Physician in Georgia

Sources for this page

Verify at the official NPI Registry.