Healthcare Provider Details

I. General information

NPI: 1447644430
Provider Name (Legal Business Name): JUHI JAIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2015
Last Update Date: 12/10/2024
Certification Date: 12/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 ERWIN RD
DURHAM NC
27705-4699
US

IV. Provider business mailing address

DUMC BOX 102382
DURHAM NC
27710-0001
US

V. Phone/Fax

Practice location:
  • Phone: 919-684-3401
  • Fax: 919-681-7950
Mailing address:
  • Phone: 919-684-3401
  • Fax: 919-681-7950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number2024-03154
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2024-03154
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: