Provider Demographics
NPI:1699587451
Name:NAIR, MAHESH SOMASEKHARAN (PT)
Entity type:Individual
Prefix:MR
First Name:MAHESH
Middle Name:SOMASEKHARAN
Last Name:NAIR
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2205 ABBOT RD STE B
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-1468
Mailing Address - Country:US
Mailing Address - Phone:517-483-2734
Mailing Address - Fax:
Practice Address - Street 1:2205 ABBOT RD STE B
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-1468
Practice Address - Country:US
Practice Address - Phone:517-483-2734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501301962225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist