Provider Demographics
NPI:1356309108
Name:NAYAK, NARESH (MD)
Entity Type:Individual
Prefix:
First Name:NARESH
Middle Name:
Last Name:NAYAK
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 1:611 SECOND ST
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750
Mailing Address - Country:US
Mailing Address - Phone:740-373-8756
Mailing Address - Fax:740-373-0091
Practice Address - Street 1:2434 RICHMILLER LN UNIT A
Practice Address - Street 2:
Practice Address - City:BELPRE
Practice Address - State:OH
Practice Address - Zip Code:45714-1075
Practice Address - Country:US
Practice Address - Phone:740-373-8756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV18940207X00000X
OH35062684207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
W60315OtherHEALTH PLAN MARIETTA
OH2007447Medicaid
WV18940AOtherHEALTH PLAN BELPRE
200028152OtherRR MEDICARE
W60315AOtherHLTH PLAN NEWMARTINSVILLE
000365917OtherBCBS
WV009844900Medicaid
000000117051OtherANTHEM
OH2007447Medicaid
000365917OtherBCBS
W60315AOtherHLTH PLAN NEWMARTINSVILLE
F98008Medicare UPIN
NA0818764Medicare ID - Type UnspecifiedSISTERSVILLE
NA0818763Medicare ID - Type UnspecifiedBELPRE