Organization
VR JASTY MD PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VENKATA RAMANA JASTY MD (PSYCHIATRIST)
(586) 484-7159
Entity
Organization
Contact information
Practice address
1525 UNIVERSITY DR, AUBURN HILLS, MI 48326-2675
(586) 484-7159
(248) 385-5771
Mailing address
6720 BIRMINGHAM CLUB DR, BLOOMFIELD HILLS, MI 48301-3119
(586) 484-7159
(248) 385-5771
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
Primary
4301057306
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4909747
—
MI
Enumeration date
12/15/2006
Last updated
12/30/2024
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