Provider Demographics
NPI:1487905105
Name:METRO RENAL ASSOCIATES, PLLC
Entity type:Organization
Organization Name:METRO RENAL ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:COSETTE
Authorized Official - Middle Name:O
Authorized Official - Last Name:JAMIESON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-877-5408
Mailing Address - Street 1:106 IRVING ST NW
Mailing Address - Street 2:SUITE 2500
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2927
Mailing Address - Country:US
Mailing Address - Phone:202-877-5408
Mailing Address - Fax:202-722-0505
Practice Address - Street 1:106 IRVING ST NW
Practice Address - Street 2:SUITE 2500
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2927
Practice Address - Country:US
Practice Address - Phone:202-877-5408
Practice Address - Fax:202-722-0505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-20
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD19681207RN0300X
DCE23075207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty