Provider Demographics
NPI:1386269108
Name:NAMBI, GANAPATHIRAM THANGAVEL ARIVUDAI (MD)
Entity type:Individual
Prefix:
First Name:GANAPATHIRAM
Middle Name:THANGAVEL ARIVUDAI
Last Name:NAMBI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:GANAPATHIRAM
Other - Middle Name:
Other - Last Name:THANGAVEL ARIVUDAINAMBI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:169 ASHLEY AVENUE
Mailing Address - Street 2:ROOM 202 MAIN HOSPITAL, MSC333
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29425
Mailing Address - Country:US
Mailing Address - Phone:843-792-0192
Mailing Address - Fax:
Practice Address - Street 1:169 ASHLEY AVENUE
Practice Address - Street 2:ROOM 202 MAIN HOSPITAL, MSC333
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425
Practice Address - Country:US
Practice Address - Phone:843-792-0192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-09
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL841612084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry