Provider Demographics
NPI:1467834408
Name:JASWA, AMRITA
Entity Type:Individual
Prefix:
First Name:AMRITA
Middle Name:
Last Name:JASWA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13008
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48901-3008
Mailing Address - Country:US
Mailing Address - Phone:517-364-3380
Mailing Address - Fax:517-364-3399
Practice Address - Street 1:1215 E. MICHIGAN AVE
Practice Address - Street 2:7TH FL TOWER WEST
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912
Practice Address - Country:US
Practice Address - Phone:517-364-3380
Practice Address - Fax:517-364-3399
Is Sole Proprietor?:No
Enumeration Date:2015-06-26
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101022049207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine