Individual
JASMINE VAYALIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
919 MAIN ST STE 102, DYER, IN 46311-3717
(219) 934-2495
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02007951A
IN
Other
Enumeration date
04/18/2021
Last updated
09/06/2024
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