Individual
PRACHEE JAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
340 JAKE ALEXANDER BLVD W, SALISBURY, NC 28147-1364
(704) 403-6260
(704) 403-6261
Mailing address
340 JAKE ALEXANDER BLVD W, SALISBURY, NC 28147-1364
(704) 403-6260
(704) 403-6261
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2007-00253
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010034477
—
VA
01
—
102872
ANTHEM
VA
01
—
232008
MEDICARE GROUP PTAN
NC
01
—
232009
MEDICARE GROUP PTAN
NC
05
—
89067A4
—
NC
Enumeration date
10/20/2006
Last updated
08/13/2012
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