Peters, Jayanthi Krishnamoorthy
Peters, Jayanthi Krishnamoorthy is an individual health care provider with primary practice located at 300 68Th St Se , Grand Rapids MI 49548-6927. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is her primary health care specialty. Peters, Jayanthi Krishnamoorthy can be contacted via phone (616) 559-5896.Contact Information
Primary practice address
300 68Th St Se
Grand Rapids MI 49548-6927
Phone: (616) 559-5896
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 35084122 | Ohio |
| Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | 35084122 | Ohio |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 01070092A | Indiana |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 4301106462 | Michigan |
Profile Details
| NPI number | 1073638227 |
|---|---|
| LBN Legal business name | Peters, Jayanthi Krishnamoorthy |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 20th, 2007 |
| Last updated | Apr 10th, 2024 - about 2 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 | 1073638227 | NPPES |
| Indiana | MEDICAID | 201032310 | |
| Indiana | Other | 000000735742 |
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