Organization
ROSEVILLE MEDICAL, P.C.
Active
Other names
Jitender K. Jain, M.D. PC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JITENDER KUMAR JAIN M.D. (OWNER)
(586) 774-9010
Entity
Organization
Contact information
Practice address
25959 KELLY RD, SUITE A, ROSEVILLE, MI 48066-4991
(586) 774-9010
(586) 774-6758
Mailing address
25959 KELLY RD, SUITE A, ROSEVILLE, MI 48066-4991
(586) 774-9010
(586) 774-6758
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
JJ033038
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E018170
BLUE CROSS BLUE SHIELD
MI
Enumeration date
03/08/2007
Last updated
01/26/2010
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