Provider Demographics
NPI:1811098247
Name:JANARTHANAN, SAILAJAH (MD)
Entity type:Individual
Prefix:DR
First Name:SAILAJAH
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 1:5555 CONNER ST
Mailing Address - Street 2:STE 2074
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48213-3448
Mailing Address - Country:US
Mailing Address - Phone:313-921-8110
Mailing Address - Fax:313-579-9221
Practice Address - Street 1:5555 CONNER ST
Practice Address - Street 2:STE 2074
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48213-3448
Practice Address - Country:US
Practice Address - Phone:313-921-8110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ35946207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ175443-01Medicaid
AZ175443-01Medicaid
AZI72172Medicare UPIN