Provider Demographics
NPI:1982652186
Name:JANARTHANAN, MAITREYI (MD)
Entity Type:Individual
Prefix:
First Name:MAITREYI
Middle Name:
Last Name:JANARTHANAN
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 1:1903 PARK AVE
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:MUSCATINE
Mailing Address - State:IA
Mailing Address - Zip Code:52761
Mailing Address - Country:US
Mailing Address - Phone:563-263-1903
Mailing Address - Fax:563-263-1904
Practice Address - Street 1:1903 PARK AVE
Practice Address - Street 2:SUITE 1500
Practice Address - City:MUSCATINE
Practice Address - State:IA
Practice Address - Zip Code:52761
Practice Address - Country:US
Practice Address - Phone:563-263-1903
Practice Address - Fax:563-263-1904
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA36998207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
L53277Medicare ID - Type Unspecified
F94469Medicare UPIN