Provider Demographics
NPI:1871548693
Name:JANI, UDAY ASHWIN (MD)
Entity type:Individual
Prefix:
First Name:UDAY
Middle Name:ASHWIN
Last Name:JANI
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 1:28312 LEWES GEORGETOWN HWY
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:DE
Mailing Address - Zip Code:19968-3115
Mailing Address - Country:US
Mailing Address - Phone:302-684-0990
Mailing Address - Fax:302-684-0991
Practice Address - Street 1:28312 LEWES GEORGETOWN HWY
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:DE
Practice Address - Zip Code:19968-3115
Practice Address - Country:US
Practice Address - Phone:302-684-0990
Practice Address - Fax:302-684-0991
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0005365207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE110239938OtherRAILROAD MEDICARE INDIV
DEG84395Medicare UPIN