Provider Demographics
NPI:1366624736
Name:NARAYANAN, MALINI VISALAM (MD)
Entity Type:Individual
Prefix:
First Name:MALINI
Middle Name:VISALAM
Last Name:NARAYANAN
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:PO BOX 2348
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20875-2348
Mailing Address - Country:US
Mailing Address - Phone:240-629-3982
Mailing Address - Fax:
Practice Address - Street 1:19506 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-5200
Practice Address - Country:US
Practice Address - Phone:240-629-3939
Practice Address - Fax:301-528-7175
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35090797207T00000X
MDD72001207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery