Provider Demographics
NPI:1851497515
Name:KARTHIKEYAN, JAYANTHI (MD)
Entity Type:Individual
Prefix:DR
First Name:JAYANTHI
Middle Name:
Last Name:KARTHIKEYAN
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 1:201 N SQUIRREL RD
Mailing Address - Street 2:#1013
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-4015
Mailing Address - Country:US
Mailing Address - Phone:248-853-8487
Mailing Address - Fax:
Practice Address - Street 1:G3267 BEECHER RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3615
Practice Address - Country:US
Practice Address - Phone:810-720-2913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301065639207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIH04466Medicare UPIN