Provider Demographics
NPI:1700822384
Name:NAIR, SATHEESH PADMANABHAN (MD)
Entity Type:Individual
Prefix:
First Name:SATHEESH
Middle Name:PADMANABHAN
Last Name:NAIR
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:PO BOX 1000
Mailing Address - Street 2:DEPT # 457
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0001
Mailing Address - Country:US
Mailing Address - Phone:901-516-9183
Mailing Address - Fax:901-516-8993
Practice Address - Street 1:1265 UNION AVE
Practice Address - Street 2:SUITE 184
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3415
Practice Address - Country:US
Practice Address - Phone:901-516-9183
Practice Address - Fax:901-516-8993
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN41288207RT0003X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207RT0003XAllopathic & Osteopathic PhysiciansInternal MedicineTransplant Hepatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP01341822OtherRAILROAD MEDICARE
AR161152001Medicaid
TN5441147Medicaid
MS07227592Medicaid
TN4355636OtherBCBS
TN5441147Medicaid
TN103I107173Medicare PIN