Individual
KISHAN KUMAR JASTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
25195 KELLY ROAD, SUITE A, ROSEVILLE, MI 48066-4909
(586) 775-4594
(586) 775-4506
Mailing address
25195 KELLY ROAD, SUITE A, ROSEVILLE, MI 48066-4909
(586) 775-4594
(586) 775-4506
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD424918
PA
207RC0000X
Cardiovascular Disease Physician
Primary
4301088186
MI
207UN0901X
Nuclear Cardiology Physician
4301088186
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060502617
BCBS
MI
05
—
1013818260002
—
PA
05
—
1346248135
—
MI
05
—
3810011127
—
WV
Enumeration date
07/14/2005
Last updated
10/16/2015
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us