Provider Demographics
NPI:1447255336
Name:NAIDOO, ABENDRA B (MD)
Entity type:Individual
Prefix:DR
First Name:ABENDRA
Middle Name:B
Last Name:NAIDOO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:218 N PEARMAN AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:MS
Mailing Address - Zip Code:38732-2634
Mailing Address - Country:US
Mailing Address - Phone:662-846-1112
Mailing Address - Fax:662-846-1170
Practice Address - Street 1:48 EAST SILVER STREET
Practice Address - Street 2:SUITE 4
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085
Practice Address - Country:US
Practice Address - Phone:413-562-8088
Practice Address - Fax:413-562-8006
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME99335207RC0000X, 207RC0001X
MA56295207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL279051300Medicaid
FLME99335OtherSTATE LICENSE
MS09702731Medicaid
P00840091OtherRAIL ROAD MEDICARE
BN3753919OtherDEA
BN3753919OtherDEA
MS09702731Medicaid