Provider Demographics
NPI:1881647857
Name:NAYYAR, RAMESH (MD)
Entity type:Individual
Prefix:DR
First Name:RAMESH
Middle Name:
Last Name:NAYYAR
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 1:2580 RHODE ISLAND AVE
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34947-4777
Mailing Address - Country:US
Mailing Address - Phone:772-461-4834
Mailing Address - Fax:
Practice Address - Street 1:2580 RHODE ISLAND AVE
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34947-4777
Practice Address - Country:US
Practice Address - Phone:772-461-4834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME30367207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL066226700Medicaid
FL77274AMedicare ID - Type Unspecified
FL066226700Medicaid