Individual
DHARMENDRA J NIMAVAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
415 N 9TH ST, SUITE 4W16, SPRINGFIELD, IL 62702-5303
(217) 544-6464
(217) 757-6844
Mailing address
PO BOX 19676, SPRINGFIELD, IL 62794-9676
(217) 544-6464
(217) 757-6844
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
036-107134
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036107134
—
IL
Enumeration date
12/05/2005
Last updated
02/09/2011
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