Provider Demographics
NPI:1386851400
Name:PEIKAR, NADER M (MD)
Entity Type:Individual
Prefix:DR
First Name:NADER
Middle Name:M
Last Name:PEIKAR
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 1:904 FALL CRK
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-8247
Mailing Address - Country:US
Mailing Address - Phone:206-291-6252
Mailing Address - Fax:817-719-2711
Practice Address - Street 1:NO. 108, CONDADO,CALLE DIEZ DE ANDINO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00911
Practice Address - Country:US
Practice Address - Phone:787-725-4097
Practice Address - Fax:787-725-4097
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15855146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant