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1578553350

NPI Code Detail

MEDICARE: SAMIR JAIN MD

MEDICARE: SAMIR JAIN MD

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	207R00000X	Internal Medicine Physician	D0061832	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3763900	OTHER	MD	AETNA HMO
2	6106139	OTHER	MD	CIGNA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	5234	OTHER	MD	BRAVO/ELDER HEALTH
5	F551-0010	OTHER	DC	CARE FIRST BLUE CROSS
6	108285	OTHER	MD	JOHNS HOPKINS HEALTH CARE
7	7931659	OTHER	MD	AETNA PPO
8	64359802	OTHER	MD	CARE FIRST BLUE CROSS

General Provider Information

NPI Number	:	1578553350
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMIR JAIN MD

Provider Business Mailing Address
First Line	:	12119 HAYLAND FARM WAY
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-6014
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1701 TWIN SPRINGS RD
Second Line	:
City	:	HALETHORPE
State	:	MD
Zip	:	21227-3553
Country	:	US
Telephone Number	:	410-737-5000
Fax Number	:

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

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	11/17/2021

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Directions to “ SAMIR JAIN MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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