Provider Demographics
NPI:1841263480
Name:DANI, JASHVANT C (MD)
Entity type:Individual
Prefix:DR
First Name:JASHVANT
Middle Name:C
Last Name:DANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:25185 WITHERSPOON ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-1365
Mailing Address - Country:US
Mailing Address - Phone:248-615-2999
Mailing Address - Fax:248-565-1850
Practice Address - Street 1:9433 JOSEPH CAMPAU ST
Practice Address - Street 2:
Practice Address - City:HAMTRAMCK
Practice Address - State:MI
Practice Address - Zip Code:48212-3435
Practice Address - Country:US
Practice Address - Phone:313-872-0398
Practice Address - Fax:313-872-0533
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-13
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301078077207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4485634Medicaid
MI4485634Medicaid
MION87810Medicare ID - Type Unspecified