Provider Demographics
NPI:1427125426
Name:MNAYARJI, NABIL E (MD)
Entity type:Individual
Prefix:
First Name:NABIL
Middle Name:E
Last Name:MNAYARJI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2505
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-2505
Mailing Address - Country:US
Mailing Address - Phone:812-238-7783
Mailing Address - Fax:812-238-4506
Practice Address - Street 1:1530 N 7TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47807-1057
Practice Address - Country:US
Practice Address - Phone:812-238-7892
Practice Address - Fax:812-238-7509
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01048818A208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200199020Medicaid
INP00264892OtherRR MEDICARE
IN200199020Medicaid
INP00264892OtherRR MEDICARE
INP00264892Medicare PIN