MEDICARE: DR. NARAYAN NAIR M.D.

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
1	207R00000X	Internal Medicine Physician	MD061965L	PA

General Provider Information

NPI Number	:	1518912724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NARAYAN NAIR M.D.

Provider Business Mailing Address
First Line	:	109 IVY HILL DR
Second Line	:
City	:	MIDDLETOWN
State	:	MD
Zip	:	21769-8135
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1434 PORTER ST
Second Line	:	BARQUST ARMY CLINIC, FORT DETRICK
City	:	FREDERICK
State	:	MD
Zip	:	21702-9210
Country	:	US
Telephone Number	:	301-619-7175
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	07/08/2007

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