Provider Demographics
NPI:1104848647
Name:JAIN, SWATI (MD)
Entity Type:Individual
Prefix:
First Name:SWATI
Middle Name:
Last Name:JAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SWATI
Other - Middle Name:
Other - Last Name:MAJUMDAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7830 MADISON AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-5607
Mailing Address - Country:US
Mailing Address - Phone:317-887-4400
Mailing Address - Fax:317-887-4401
Practice Address - Street 1:7830 MADISON AVE
Practice Address - Street 2:SUITE A
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-5607
Practice Address - Country:US
Practice Address - Phone:317-887-4400
Practice Address - Fax:317-887-4401
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01062931A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200853410Medicaid
IN000000512133OtherANTHEM
IN200853410Medicaid