Jasti, Kishan Kumar
Jasti, Kishan Kumar is an individual health care provider with primary practice located at 25195 Kelly Road Suite A, Roseville MI 48066-4909. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Nuclear Cardiology. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Jasti, Kishan Kumar can be contacted via phone (586) 775-4594.Contact Information
Primary practice address
25195 Kelly Road Suite A
Roseville MI 48066-4909
Phone: (586) 775-4594
Fax: (586) 775-4506
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD424918 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 4301088186 | Michigan |
| Allopathic & Osteopathic Physicians / Nuclear Cardiology | 207UN0901X | 4301088186 | Michigan |
Profile Details
| NPI number | 1346248135 |
|---|---|
| LBN Legal business name | Jasti, Kishan Kumar |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 14th, 2005 |
| Last updated | Oct 16th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346248135 | NPPES |
| West Virginia | MEDICAID | 3810011127 | |
| West Virginia | Other | 060502617 | |
| West Virginia | MEDICAID | 1013818260002 | |
| West Virginia | MEDICAID | 1346248135 |
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