Individual
JITENDER KUMAR JAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
25959 KELLY RD, STE A, ROSEVILLE, MI 48066-4991
(586) 774-9010
(586) 774-6758
Mailing address
25959 KELLY RD, STE A, ROSEVILLE, MI 48066-4991
(586) 774-9010
(586) 774-6758
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
JJ033038
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05017972
FEDERAL EMPLOYEE PLAN
MI
01
—
123770
TOTAL HEALTH PLAN
MI
01
—
137717
CARE CHOICES
MI
05
—
2101890
—
MI
01
—
830004296
RAILROAD MEDICARE
MI
Enumeration date
07/18/2006
Last updated
01/30/2012
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