Individual
MUKESH JAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
75 FRANCIS ST, BWH CARDIOVASCULAR DIV, BOSTON, MA 02115
(617) 278-0175
Mailing address
20 BLOSSOM ST, LEXINGTON, MA 02421-8110
(617) 278-0175
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
78028
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000224379
UNISON
OH
01
—
000000539506
ANTHEM
OH
05
—
2683332
—
OH
01
—
363664
WELLCARE
OH
01
—
7013147
AETNA
OH
01
—
743245
BUCKEYE
OH
01
—
P00432700
RAILROAD MEDICARE
OH
Enumeration date
07/21/2006
Last updated
01/13/2021
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