Healthcare Provider Details

I. General information

NPI: 1770758872
Provider Name (Legal Business Name): HARESH JANI MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2008
Last Update Date: 06/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2575 SPRING ARBOR RD STE 400
JACKSON MI
49203-3652
US

IV. Provider business mailing address

2575 SPRING ARBOR RD STE 400
JACKSON MI
49203-3652
US

V. Phone/Fax

Practice location:
  • Phone: 517-787-7844
  • Fax: 517-783-5044
Mailing address:
  • Phone: 517-787-7844
  • Fax: 517-783-5044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberHJ064728
License Number StateMI

VIII. Authorized Official

Name: DR. HARESH JANI
Title or Position: OWNER
Credential: MD
Phone: 517-787-7844