Provider Demographics
NPI:1215932892
Name:JANDE, HARPAL (MD)
Entity type:Individual
Prefix:
First Name:HARPAL
Middle Name:
Last Name:JANDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58024 VAN DYKE RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48094-4518
Mailing Address - Country:US
Mailing Address - Phone:586-781-5535
Mailing Address - Fax:586-540-1220
Practice Address - Street 1:58024 VAN DYKE RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MI
Practice Address - Zip Code:48094-4518
Practice Address - Country:US
Practice Address - Phone:586-781-5535
Practice Address - Fax:586-540-1220
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301066612207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4923432Medicaid
MIHJ066612OtherBCBSM
MIP24580042Medicare PIN
MI4923432Medicaid
G84415Medicare UPIN