Provider Demographics
NPI:1245229343
Name:NAIR, VIMALA P (MD)
Entity type:Individual
Prefix:DR
First Name:VIMALA
Middle Name:P
Last Name:NAIR
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Gender:F
Credentials:MD
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Mailing Address - Street 1:100 LACY ST NW
Mailing Address - Street 2:SUITE 150
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1113
Mailing Address - Country:US
Mailing Address - Phone:770-793-7635
Mailing Address - Fax:770-793-7645
Practice Address - Street 1:100 LACY ST NW
Practice Address - Street 2:SUITE 150
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1113
Practice Address - Country:US
Practice Address - Phone:770-793-7635
Practice Address - Fax:770-793-7645
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2019-09-27
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Provider Licenses
StateLicense IDTaxonomies
GA18058208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation