Basic Information
| Provider Information | |||||||||
| NPI: | 1093753519 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NAGULENDRAN | ||||||||
| FirstName: | NIRMALAM | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13804 BRIARWOOD DR SW | ||||||||
| Address2: | |||||||||
| City: | CUMBERLAND | ||||||||
| State: | MD | ||||||||
| PostalCode: | 215026502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3017296077 | ||||||||
| FaxNumber: | 3017775630 | ||||||||
| Practice Location | |||||||||
| Address1: | 12500 WILLOWBROOK RD | ||||||||
| Address2: | |||||||||
| City: | CUMBERLAND | ||||||||
| State: | MD | ||||||||
| PostalCode: | 215022554 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3017775627 | ||||||||
| FaxNumber: | 3017775630 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0804X | D21089 | MD | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry |
No ID Information.