Provider Demographics
NPI:1417367756
Name:KADO, JENNA TERESA (MD)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:TERESA
Last Name:KADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 N SUMMIT ST FL 7
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1531
Mailing Address - Country:US
Mailing Address - Phone:734-430-3151
Mailing Address - Fax:419-479-2696
Practice Address - Street 1:730 N MACOMB ST STE 300
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-2904
Practice Address - Country:US
Practice Address - Phone:734-430-3151
Practice Address - Fax:419-479-2696
Is Sole Proprietor?:No
Enumeration Date:2014-05-07
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43011058912084S0012X, 2084N0400X
OH35.1404462084N0400X, 2084S0012X
VA01012803822084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology