Provider Demographics
NPI:1992981153
Name:NAIR, SRIDHAR G (MD)
Entity type:Individual
Prefix:DR
First Name:SRIDHAR
Middle Name:G
Last Name:NAIR
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 1:9590 E IRONWOOD SQUARE DR
Mailing Address - Street 2:STE 125
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4583
Mailing Address - Country:US
Mailing Address - Phone:480-455-3000
Mailing Address - Fax:
Practice Address - Street 1:612 W BASELINE RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-6041
Practice Address - Country:US
Practice Address - Phone:480-834-9039
Practice Address - Fax:480-964-7802
Is Sole Proprietor?:No
Enumeration Date:2008-01-17
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD426357207R00000X
CAA104090207RN0300X
AZ48209207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ160242Medicare PIN