Provider Demographics
NPI:1811077563
Name:NAIR, CHANDRASEKHARAN (MD)
Entity type:Individual
Prefix:DR
First Name:CHANDRASEKHARAN
Middle Name:
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 1:5601 LOCH RAVEN BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239
Mailing Address - Country:US
Mailing Address - Phone:410-532-3898
Mailing Address - Fax:410-532-3854
Practice Address - Street 1:5601 LOCH RAVEN BLVD
Practice Address - Street 2:STE 100
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21239
Practice Address - Country:US
Practice Address - Phone:410-532-3898
Practice Address - Fax:410-532-3854
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0021778207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD278462OtherOPTINIUM CHOICE
04386OtherAMERICAID
MD278462OtherALLIANCE
MD278462OtherMDIPA
MD25231OtherEHP
MD278462OtherMAMSI
30111004OtherAETNA
6540Medicare ID - Type Unspecified
MD278462OtherMDIPA