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1245235654

NPI Code Detail

MEDICARE: JOHN IMAD JARAD M.D.

MEDICARE: JOHN IMAD JARAD 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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	061093	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	0P225700002	OTHER	MI	MEDICARE PROVIDER PIN
5	2366756	OTHER	MI	AETNA MEDICARE ADVANTAGE
6	DG3605	OTHER	MI	RAILROAD MEDICARE GROUP PIN
10	110196407	OTHER	MI	RAILROAD MEDICARE PROVIDER PIN
12	1107401082	OTHER	MI	MEDICARE PLUS BLUE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0994185	OTHER	MI	HEALTHPLUS
2	G35455	OTHER	MI	HAP/CIGNA
4	105910404081	OTHER	MI	HUMANA
7	G35455	OTHER	MI	ALLIANCE HEALTH PLAN
8	1417675	OTHER	MI	UNITED HEALTH CARE
9	900040508	OTHER	MI	PRIORITY HEALTH
11	1107401082	OTHER	MI	BCBSM
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245235654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN IMAD JARAD M.D.

Provider Business Mailing Address
First Line	:	2540 16TH ST
Second Line	:
City	:	PORT HURON
State	:	MI
Zip	:	48060-6405
Country	:	US
Telephone Number	:	810-987-1000
Fax Number	:	810-982-1810

Provider Business Practice Location Address
First Line	:	2540 16TH ST
Second Line	:
City	:	PORT HURON
State	:	MI
Zip	:	48060-6405
Country	:	US
Telephone Number	:	810-987-1000
Fax Number	:	810-982-1810

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

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	02/06/2015

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Directions to “ JOHN IMAD JARAD M.D.” Practice Location

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