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NPI Code Detail

MEDICARE: MR. VIVEK NAIR AA

MEDICARE: MR. VIVEK NAIR AA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367H00000XAnesthesiologist Assistant91-017WI
2367H00000XAnesthesiologist Assistant1343TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275896367
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. VIVEK NAIR AA
Provider Business Mailing Address
First Line : 4025 N 92ND ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53222-1613
Country : US
Telephone Number : 414-358-5431
Fax Number : 414-358-5421
Provider Business Practice Location Address
First Line : 4025 N 92ND ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53222-1613
Country : US
Telephone Number : 414-358-5431
Fax Number : 414-358-5421
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2012
Last Update Date : 11/22/2021

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