Provider Demographics
NPI:1952486425
Name:JAIN, SUNEIL (NMD)
Entity Type:Individual
Prefix:DR
First Name:SUNEIL
Middle Name:
Last Name:JAIN
Suffix:
Gender:M
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35360 N 93RD WAY
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85262-1150
Mailing Address - Country:US
Mailing Address - Phone:480-540-9068
Mailing Address - Fax:480-551-9305
Practice Address - Street 1:9977 N 95TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4595
Practice Address - Country:US
Practice Address - Phone:480-551-9000
Practice Address - Fax:480-551-9305
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ 04-827175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath