Healthcare Provider Details
I. General information
NPI: 1407237209
Provider Name (Legal Business Name): NADIR KHARMA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/17/2015
Last Update Date: 07/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1400 BELLINGER ST
EAU CLAIRE WI
54703-5222
US
IV. Provider business mailing address
1400 BELLINGER ST
EAU CLAIRE WI
54703-5222
US
V. Phone/Fax
- Phone: 715-838-5222
- Fax:
- Phone: 715-838-5222
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084S0012X |
| Taxonomy | Sleep Medicine (Psychiatry & Neurology) Physician |
| License Number | 59167 |
| License Number State | MN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | 65885-20 |
| License Number State | WI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: