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Individual

DR. KRISHNA MOHAN JAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1815 HENSON AVE, KALAMAZOO, MI 49048-1510
(269) 492-6500
(269) 492-6461
Mailing address
1815 HENSON AVE, KALAMAZOO, MI 49048-1510
(269) 492-6500
(269) 492-6461

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
4301043579
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1013972769
MI
01
1417961137
BCBSM - BMH
MI
05
341660510
MI
01
3733063
PHP
MI
01
4309785
AETNA
MI
01
P53787
BLUE CARE NETWORK PROVIDE
MI
Enumeration date
04/18/2006
Last updated
04/12/2011
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