Provider Demographics
NPI:1972566909
Name:NAIR, SREEDHARAN D (MD)
Entity type:Individual
Prefix:DR
First Name:SREEDHARAN
Middle Name:D
Last Name:NAIR
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:D.S.
Other - Middle Name:
Other - Last Name:NAIR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:37664 FORD RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-1924
Mailing Address - Country:US
Mailing Address - Phone:734-326-6710
Mailing Address - Fax:734-326-6711
Practice Address - Street 1:37664 FORD RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-1924
Practice Address - Country:US
Practice Address - Phone:734-326-6710
Practice Address - Fax:734-326-6711
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC1617322084P0800X
MI43010323242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIN15280016Medicare ID - Type Unspecified
MIA77075Medicare UPIN