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NPI Code Detail

MEDICARE: PRABHAKARAN K NAMBIAR MD

MEDICARE: PRABHAKARAN K NAMBIAR MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12081P0004XSpinal Cord Injury Medicine Physician0101038579VA

General Provider Information

NPI Number : 1386662203
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRABHAKARAN K NAMBIAR MD
Provider Business Mailing Address
First Line : 3700 N WINDSONG DR
Second Line :
City : PRESCOTT VALLEY
State : AZ
Zip : 86314-1253
Country : US
Telephone Number : 928-759-8800
Fax Number : 928-443-8941
Provider Business Practice Location Address
First Line : 3700 N WINDSONG DR
Second Line :
City : PRESCOTT VALLEY
State : AZ
Zip : 86314-1253
Country : US
Telephone Number : 928-759-8800
Fax Number : 804-861-0050
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 03/17/2021

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