Provider Demographics
NPI:1770758872
Name:HARESH JANI MD PC
Entity type:Organization
Organization Name:HARESH JANI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARESH
Authorized Official - Middle Name:
Authorized Official - Last Name:JANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-787-7844
Mailing Address - Street 1:2575 SPRING ARBOR RD
Mailing Address - Street 2:STE 400
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-3652
Mailing Address - Country:US
Mailing Address - Phone:517-787-7844
Mailing Address - Fax:517-783-5044
Practice Address - Street 1:2575 SPRING ARBOR RD
Practice Address - Street 2:STE 400
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-3652
Practice Address - Country:US
Practice Address - Phone:517-787-7844
Practice Address - Fax:517-783-5044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2009-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIHJ064728207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0603845542OtherBCBSM
MI103237936Medicaid
MI103237936Medicaid
MI0603845542OtherBCBSM