MEDICARE: JASHVANT DANI MDPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1275850554
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JASHVANT DANI MDPC

Provider Business Mailing Address
First Line	:	25185 WITHERSPOON ST
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48335-1365
Country	:	US
Telephone Number	:	248-565-1850
Fax Number	:	248-615-2999

Provider Business Practice Location Address
First Line	:	9433 JOSEPH CAMPAU ST
Second Line	:
City	:	HAMTRAMCK
State	:	MI
Zip	:	48212-3435
Country	:	US
Telephone Number	:	313-872-0398
Fax Number	:	313-872-0533

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JASHVANT C DANI
Credential	:	M.D.
Telephone Number	:	248-615-2999

Provider Enumeration Date	:	04/27/2010
Last Update Date	:	04/27/2010

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