Provider Demographics
NPI:1245223411
Name:NADAR, ANBU K (MD)
Entity Type:Individual
Prefix:DR
First Name:ANBU
Middle Name:K
Last Name:NADAR
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 1:419 TOWN MOUNTAIN RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-1631
Mailing Address - Country:US
Mailing Address - Phone:606-432-0016
Mailing Address - Fax:
Practice Address - Street 1:911 BYPASS RD BLDG A
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-1689
Practice Address - Country:US
Practice Address - Phone:606-430-2206
Practice Address - Fax:606-218-7506
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-23
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY23240207X00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64232408Medicaid
KY1551301Medicare ID - Type Unspecified
KY64232408Medicaid