MEDICARE: SUDHIR K NAYER MD & ASSOC PA

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
1	261QP2300X	Primary Care Clinic/Center	ME20859	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962707174
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUDHIR K NAYER MD & ASSOC PA

Provider Business Mailing Address
First Line	:	8501 S US HIGHWAY 1
Second Line	:	SUITE 10
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-3346
Country	:	US
Telephone Number	:	772-879-0008
Fax Number	:	772-879-4504

Provider Business Practice Location Address
First Line	:	8501 S US HIGHWAY 1
Second Line	:	SUITE 10
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-3346
Country	:	US
Telephone Number	:	772-879-0008
Fax Number	:	772-879-4504

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SUDHIR K NAYER
Credential	:	MD
Telephone Number	:	772-879-0008

Provider Enumeration Date	:	01/19/2011
Last Update Date	:	01/19/2011

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