Individual
NISHANT K VAIDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2424 S 90TH ST FL 2, WEST ALLIS, WI 53227-2455
(414) 328-8777
(414) 328-8110
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
22500
WI
207R00000X
Internal Medicine Physician
274998
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100206707
—
WI
Enumeration date
06/06/2010
Last updated
07/23/2025
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