Provider Demographics
NPI:1568224632
Name:NAYAK INTERNAL MEDICINE LLC
Entity Type:Organization
Organization Name:NAYAK INTERNAL MEDICINE LLC
Other - Org Name:STELLAR MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INTERNIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHWINI
Authorized Official - Middle Name:N
Authorized Official - Last Name:AMMUNJE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-900-5181
Mailing Address - Street 1:8765 W KELTON LANE UNIT B1
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-3584
Mailing Address - Country:US
Mailing Address - Phone:480-287-3026
Mailing Address - Fax:
Practice Address - Street 1:8765 W KELTON LN UNIT B1
Practice Address - Street 2:SUITE 110
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-3584
Practice Address - Country:US
Practice Address - Phone:480-799-3003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-25
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty