Provider Demographics
NPI:1386664241
Name:NAIR, SANTHI BALAKRISHNAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SANTHI
Middle Name:BALAKRISHNAN
Last Name:NAIR
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 1:2217 PRINCESS ANNE ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-3353
Mailing Address - Country:US
Mailing Address - Phone:540-735-0560
Mailing Address - Fax:540-735-0567
Practice Address - Street 1:2217 PRINCESS ANNE ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3353
Practice Address - Country:US
Practice Address - Phone:540-735-0560
Practice Address - Fax:540-735-0567
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD423660208000000X
VA0101240390208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1011234740001Medicaid
PAI21299Medicare UPIN