Provider Demographics
NPI:1851307680
Name:JAIN, GAURAV (MD)
Entity Type:Individual
Prefix:
First Name:GAURAV
Middle Name:
Last Name:JAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:537 STANTON CHRISTIANA RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713
Mailing Address - Country:US
Mailing Address - Phone:302-225-2380
Mailing Address - Fax:302-225-2388
Practice Address - Street 1:537 STANTON CHRISTIANA RD
Practice Address - Street 2:SUITE 203
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713
Practice Address - Country:US
Practice Address - Phone:302-225-2380
Practice Address - Fax:302-225-2388
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC10006985207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000033352Medicaid
7510505OtherAETNA
DEH97372OtherBCBS
DEH97372OtherBCBS
DE012780M93Medicare PIN