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Individual

THAN MAL JAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
970 E WASHINGTON ST, STE 2-E, MEDINA, OH 44256
(330) 722-8707
(330) 723-5679
Mailing address
PO BOX 638269, CINCINNATI, OH 45263-0001
(330) 722-8707
(330) 723-5679

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
046687
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0559131
OH
01
060027690
RAILROAD MEDICARE
OH
Enumeration date
06/26/2006
Last updated
09/18/2023
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