Provider Demographics
NPI:1689861049
Name:JAIN, INDU (MD)
Entity Type:Individual
Prefix:
First Name:INDU
Middle Name:
Last Name:JAIN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:130 TOWN CENTER DR
Mailing Address - Street 2:STE 203
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-1744
Mailing Address - Country:US
Mailing Address - Phone:248-585-8216
Mailing Address - Fax:248-585-8266
Practice Address - Street 1:3535 W 13 MILE RD STE 707
Practice Address - Street 2:BEAUMONT PEDIATRIC PULMONARY MEDICINE
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6770
Practice Address - Country:US
Practice Address - Phone:248-551-0487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2020-10-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301089240208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics