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General NPI Number Information
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NPI Number | 1619084589
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Entity Type | Organization
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Legal Business Name | K C R NAIR MD PC
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 01/17/2008
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Provider Practice Location Address
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Address Line | 15645 FARMINGTON RD
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City | LIVONIA
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State | MI
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Zip | 48154-2851
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Country | US
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Telephone | 734-425-5320
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Fax | 734-425-6212
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Provider Business Mailing Address
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Address Line | 15645 FARMINGTON RD
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City | LIVONIA
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State | MI
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Zip | 48154-2851
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Country | US
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Telephone | 734-425-5320
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Fax | 734-425-6212
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. K C R NAIR
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Credential | M.D.
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Telephone | 734-425-5320
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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 | 4301031280
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License Number State | MI
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