Provider Demographics
NPI:1891790663
Name:PILLAY, JEET N (MD)
Entity type:Individual
Prefix:
First Name:JEET
Middle Name:N
Last Name:PILLAY
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 1:100 N POND DR
Mailing Address - Street 2:STE C
Mailing Address - City:WALLED LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48390-3079
Mailing Address - Country:US
Mailing Address - Phone:248-624-2222
Mailing Address - Fax:248-926-9455
Practice Address - Street 1:100 N POND DR
Practice Address - Street 2:STE C
Practice Address - City:WALLED LAKE
Practice Address - State:MI
Practice Address - Zip Code:48390-3079
Practice Address - Country:US
Practice Address - Phone:248-624-2222
Practice Address - Fax:248-926-9455
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4310083902207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4618534Medicaid
7590588OtherAETNA
MIX20835OtherHAP HMO PPO
MI3120987OtherCIGNA
MII09597OtherHAP
MI139063OtherCARE CHOICES
MI1106302861OtherBCBSM
MI2225559OtherFIRST HEALTH
MIX20835OtherHAP
MI0630286OtherBCE EMERGIS
7590588OtherAETNA
MI139063OtherCARE CHOICES
MI1106302861OtherBCBSM