Provider Demographics
NPI:1609860238
Name:SRIKUMAR, NADARAJAH (MD)
Entity Type:Individual
Prefix:DR
First Name:NADARAJAH
Middle Name:
Last Name:SRIKUMAR
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 1:1600 S 48TH ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-1283
Mailing Address - Country:US
Mailing Address - Phone:402-483-3333
Mailing Address - Fax:402-483-3297
Practice Address - Street 1:4508 38TH ST
Practice Address - Street 2:SUITE 165
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-1668
Practice Address - Country:US
Practice Address - Phone:402-562-4456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2011-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93077207RC0000X
NE25728207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47084496100Medicaid
KS2006655820AOtherMCD NE LOCATION
F95402Medicare UPIN
NE47084496100Medicaid
FL15645YMedicare PIN