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General NPI Number Information
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NPI Number | 1225272529
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Entity Type | Individual
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Provider Name | ANIL NAIR M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/30/2009
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Last Update Date | 08/18/2020
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Provider Practice Location Address
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Address Line | 113 GAINSBOROUGH SQ STE 300
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City | CHESAPEAKE
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State | VA
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Zip | 23320-1714
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Country | US
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Telephone | 757-547-9286
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Fax |
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Provider Business Mailing Address
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Address Line | 515 MIDDLE TPKE W
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City | MANCHESTER
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State | CT
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Zip | 06040-3816
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Country | US
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Telephone | 860-646-3814
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 048578
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101269507
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License Number State | VA
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