Provider Demographics
NPI:1801861554
Name:NAIR, VIJAYACHANDRA SEKHARAN (MD)
Entity Type:Individual
Prefix:
First Name:VIJAYACHANDRA
Middle Name:SEKHARAN
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 1:602 S ATWOOD RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4172
Mailing Address - Country:US
Mailing Address - Phone:410-877-7777
Mailing Address - Fax:410-638-9956
Practice Address - Street 1:602 S ATWOOD RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4172
Practice Address - Country:US
Practice Address - Phone:410-877-7777
Practice Address - Fax:410-638-9956
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0016444174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD221091600Medicaid
MD34388001OtherCAREFIRST
MD028921300Medicaid
MD6358Medicare PIN
MD34388001OtherCAREFIRST