Provider Demographics
NPI:1134812100
Name:JAIN, SRIMATHY (MD, MS)
Entity type:Individual
Prefix:DR
First Name:SRIMATHY
Middle Name:
Last Name:JAIN
Suffix:
Gender:F
Credentials:MD, MS
Other - Prefix:DR
Other - First Name:MATTIE
Other - Middle Name:
Other - Last Name:JAIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, MS
Mailing Address - Street 1:PO BOX 168
Mailing Address - Street 2:
Mailing Address - City:ST MARYS CITY
Mailing Address - State:MD
Mailing Address - Zip Code:20686-0168
Mailing Address - Country:US
Mailing Address - Phone:240-309-2424
Mailing Address - Fax:
Practice Address - Street 1:600 N WOLFE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0005
Practice Address - Country:US
Practice Address - Phone:240-309-2424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program