Individual
DR. JAHNAVI MITHYANTHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
601 JOHN ST, BOX 74, KALAMAZOO, MI 49007-5341
(269) 341-8481
(269) 341-7781
Mailing address
601 JOHN ST, BOX 74, KALAMAZOO, MI 49007-5341
(269) 341-8481
(269) 341-7781
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301087292
MI
207R00000X
Internal Medicine Physician
43420
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417151911
—
MI
01
—
1417961137
BCBSM - BMH
MI
Enumeration date
06/11/2007
Last updated
11/27/2023
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