Individual
MANISH JAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2651 E DISCOVERY PKWY, BLOOMINGTON, IN 47408-9059
(812) 331-3400
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01071439A
IN
207RN0300X
Nephrology Physician
Primary
01071439A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201077340
—
IN
01
—
232359401
MAIN LINE HEALTHCARE
PA
Enumeration date
12/14/2006
Last updated
01/22/2026
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