Provider Demographics
NPI:1295957215
Name:ANBU K. NADAR M.D., PSC
Entity type:Organization
Organization Name:ANBU K. NADAR M.D., PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANBU
Authorized Official - Middle Name:K
Authorized Official - Last Name:NADAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-432-0016
Mailing Address - Street 1:419 TOWN MOUNTAIN RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-1631
Mailing Address - Country:US
Mailing Address - Phone:606-432-0016
Mailing Address - Fax:606-437-6369
Practice Address - Street 1:419 TOWN MOUNTAIN RD
Practice Address - Street 2:SUITE 107
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-1631
Practice Address - Country:US
Practice Address - Phone:606-432-0016
Practice Address - Fax:606-437-6369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY23240207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0436330001Medicare NSC