Healthcare Provider Details

I. General information

NPI: 1851786867
Provider Name (Legal Business Name): JASKIRAN KAUR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2015
Last Update Date: 06/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 SAINT ANTOINE ST 6-C, UHC
DETROIT MI
48201-2153
US

IV. Provider business mailing address

16001 W 9 MILE RD
SOUTHFIELD MI
48075-4818
US

V. Phone/Fax

Practice location:
  • Phone: 313-577-5009
  • Fax:
Mailing address:
  • Phone: 313-896-8749
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: