Provider Demographics
NPI:1760486583
Name:JANI, HARESH (MD)
Entity type:Individual
Prefix:DR
First Name:HARESH
Middle Name:
Last Name:JANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5894 MARENGO ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-8315
Mailing Address - Country:US
Mailing Address - Phone:517-787-7844
Mailing Address - Fax:517-783-5044
Practice Address - Street 1:2575 SPRING ARBOR RD
Practice Address - Street 2:STE 400
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-3652
Practice Address - Country:US
Practice Address - Phone:517-787-7844
Practice Address - Fax:517-783-5044
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIHJ4301064728207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3237936-10Medicaid
MI3237936-10Medicaid
MI0M23620Medicare ID - Type Unspecified