Provider Demographics
NPI:1346285319
Name:XAVIER, NIRAJ PHILLIP (MD)
Entity Type:Individual
Prefix:
First Name:NIRAJ
Middle Name:PHILLIP
Last Name:XAVIER
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:PO BOX 18488
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35804-8488
Mailing Address - Country:US
Mailing Address - Phone:256-534-8659
Mailing Address - Fax:
Practice Address - Street 1:751 PLEASANT ROW NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35816-2537
Practice Address - Country:US
Practice Address - Phone:256-533-6311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17555208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALF69587Medicare UPIN