Provider Demographics
NPI:1427028398
Name:JAIN, ASHOKKUMAR CHATARMALJI (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHOKKUMAR
Middle Name:CHATARMALJI
Last Name:JAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 647
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-0647
Mailing Address - Country:US
Mailing Address - Phone:910-483-7337
Mailing Address - Fax:910-483-0648
Practice Address - Street 1:216 E BROAD ST
Practice Address - Street 2:
Practice Address - City:SAINT PAULS
Practice Address - State:NC
Practice Address - Zip Code:28384-1612
Practice Address - Country:US
Practice Address - Phone:910-241-3136
Practice Address - Fax:910-241-3159
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-24
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200101222174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1427028398OtherHUMANA
NC1427028398Medicaid
NC624256OtherWELLPATH
NC1342HOtherBCBS PROVIDER ID NUMBER
NC1427028Medicaid
NCC4360OtherMEDCOST
NC7557270OtherAETNA
NC1427028398OtherDOCTORS DIRECT
NC200101222OtherPROVIDER LICENCE NUMBER
NC2056201OtherUNITED HEALTHCARE
NC624256OtherCOVENTRY OF THE CAROLINAS
NC872500OtherCOVENTRY NATIONAL - COVENTRY PPO
NC12220189OtherPHCS-MULTIPLAN
NC1427028398OtherHEALTHNET FEDERAL SERVICES
NC891342HMedicaid
NC1427028398OtherHEALTHSMART
NC3812490OtherCIGNA-GREATWEST
NCFH1101565OtherFIRST CAROLINA CARE
NC1427028398Medicaid
NC624256OtherCOVENTRY OF THE CAROLINAS