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General NPI Number Information
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NPI Number | 1033256961
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Entity Type | Organization
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Legal Business Name | SREEKUMAR NAIR MD LLC
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 10/15/2008
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Provider Practice Location Address
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Address Line | 4031 NE LAKEWOOD WAY STE 100
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City | LEES SUMMIT
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State | MO
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Zip | 64064
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Country | US
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Telephone | 816-795-1881
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Fax | 816-795-1212
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Provider Business Mailing Address
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Address Line | 4031 NE LAKEWOOD WAY STE 100
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City | LEES SUMMIT
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State | MO
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Zip | 64064
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Country | US
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Telephone | 816-795-1881
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Fax | 816-795-1212
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Authorized Official
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Title or Position | OWNER
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Name | DR. SREEKUMAR P NAIR
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Credential | M.D.
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Telephone | 816-795-1881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 105097
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License Number State | MO
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