Individual
DR. SIDHARTH JAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3200 MACCORKLE AVE SE STE B-16, CHARLESTON, WV 25304-1297
(304) 388-5848
(304) 388-9654
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6400
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
32595
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8KU309
BCBS
TX
Enumeration date
02/10/2014
Last updated
09/28/2023
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