MEDICARE: DR. ANIL K JAIN M.D.

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	2084P0800X	Psychiatry Physician	4301048210	MI

General Provider Information

NPI Number	:	1013027309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANIL K JAIN M.D.

Provider Business Mailing Address
First Line	:	300 CORNELL ST
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48188-1000
Country	:	US
Telephone Number	:	734-751-3037
Fax Number	:	734-591-3182

Provider Business Practice Location Address
First Line	:	4483 LAUREL CLUB CIR APT 25
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48323-2905
Country	:	US
Telephone Number	:	734-751-3037
Fax Number	:	734-591-3182

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	12/11/2025

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