Healthcare Provider Details

I. General information

NPI: 1598497513
Provider Name (Legal Business Name): JEMEERA JEYAMUHUNTHAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2022
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37595 SEVEN MILE ROAD SUITE 340
LIVONIA MI
48152
US

IV. Provider business mailing address

101 JADE CRESCENT
WOODBRIDGE ONTARIO
L4L6M1
CA

V. Phone/Fax

Practice location:
  • Phone: 734-793-2470
  • Fax: 734-793-2471
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number73884
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: