Healthcare Provider Details

I. General information

NPI: 1669494258
Provider Name (Legal Business Name): SREEKUMAR NAIR, MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 06/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4031 NE LAKEWOOD WAY STE 100
LEES SUMMIT MO
64064-2060
US

IV. Provider business mailing address

4031 NE LAKEWOOD WAY STE 100
LEES SUMMIT MO
64064-2060
US

V. Phone/Fax

Practice location:
  • Phone: 816-795-1881
  • Fax: 816-795-1212
Mailing address:
  • Phone: 816-795-1881
  • Fax: 816-795-1212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SREEKUMAR NAIR
Title or Position: OWNER
Credential: MD
Phone: 816-795-1881