Individual
DR. PRIYAMVADA NAGESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1200 N WEST AVE,, RECOVERY TECHNOLOGY, SUITE 400, JACKSON, MI 49202-2179
(517) 780-3336
(517) 796-4561
Mailing address
1200 N WEST AVE,, RECOVERY TECHNOLOGY, SUITE 400, JACKSON, MI 49202-2179
(517) 780-3336
(517) 796-4561
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
046503
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260C876120
BLUE CROSS BLUE SHIELD
MI
05
—
3061977
—
MI
Enumeration date
08/18/2006
Last updated
07/13/2011
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