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Individual

NIRAJ UPADHAYAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017
(859) 301-8074
(859) 301-4945
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 301-8074
(859) 301-4945

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
46322
KY
208M00000X
Hospitalist Physician
036125356
IL
208M00000X
Hospitalist Physician
Primary
46322
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0087703
OH
05
036125356
IL
01
3932056
BCBS
IL
05
7100259620
KY
01
721089
AETNA
IL
Enumeration date
08/17/2007
Last updated
03/15/2022
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