Provider Demographics
NPI:1346863008
Name:MAINI, NAYNA (MD)
Entity Type:Individual
Prefix:MS
First Name:NAYNA
Middle Name:
Last Name:MAINI
Suffix:
Gender:F
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:WUSM PEDS
Mailing Address - Street 2:1 CHILDRENS PLACE CB 8116
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110
Mailing Address - Country:US
Mailing Address - Phone:314-454-6124
Mailing Address - Fax:844-616-1418
Practice Address - Street 1:WUSM PEDS
Practice Address - Street 2:1 CHILDRENS PLACE CB 8116
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110
Practice Address - Country:US
Practice Address - Phone:314-454-6124
Practice Address - Fax:844-616-1418
Is Sole Proprietor?:No
Enumeration Date:2020-05-28
Last Update Date:2023-07-17
Deactivation Date:2022-01-18
Deactivation Code:
Reactivation Date:2023-03-08
Provider Licenses
StateLicense IDTaxonomies
MO00000000000208000000X
390200000X
MO2023026679208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program