Provider Demographics
NPI:1982374302
Name:NADIR, RANDOLPH JAMES (PA-C)
Entity Type:Individual
Prefix:MR
First Name:RANDOLPH
Middle Name:JAMES
Last Name:NADIR
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:360 US HIGHWAY 1 BYP UNIT 102
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7105
Mailing Address - Country:US
Mailing Address - Phone:603-410-6700
Mailing Address - Fax:603-319-8308
Practice Address - Street 1:419B ANDOVER ST
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-5001
Practice Address - Country:US
Practice Address - Phone:978-620-5048
Practice Address - Fax:978-620-5073
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-16
Last Update Date:2023-11-16
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Provider Licenses
StateLicense IDTaxonomies
MAPA9011363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant