Healthcare Provider Details

I. General information

NPI: 1447540950
Provider Name (Legal Business Name): ATHIRA UPENDRAN NAIR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2011
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 AIRPORT BLVD
MOBILE AL
36606-1701
US

IV. Provider business mailing address

2055 AIRPORT BLVD
MOBILE AL
36606-1701
US

V. Phone/Fax

Practice location:
  • Phone: 251-234-1625
  • Fax:
Mailing address:
  • Phone: 251-234-1625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA142080
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberA142080
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number41706
License Number StateAL
# 4
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number41706
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: