Provider Demographics
NPI:1346217023
Name:NAYAR, RAJEEV (MD)
Entity Type:Individual
Prefix:
First Name:RAJEEV
Middle Name:
Last Name:NAYAR
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 1:3033 S 27TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-3600
Mailing Address - Country:US
Mailing Address - Phone:414-908-6601
Mailing Address - Fax:414-385-2980
Practice Address - Street 1:2801 W KK RIVER PKWY
Practice Address - Street 2:SUITE 1030
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215-3669
Practice Address - Country:US
Practice Address - Phone:414-908-6500
Practice Address - Fax:414-385-2980
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI39631-020207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32432500Medicaid
WIG19320Medicare UPIN