Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 5101016195 | MI |
Y | 207QA0401X | Family Doctor - Addiction Medicine | 5101016195 | MI |
N | 208D00000X | General Practice Physician | 5101016195 | MI |
NPI | 1023234200 |
---|---|
Provider Name | Dr. Janis Elizabeth Romanik |
First Address | Richmond, MI 48062-2505 |
Second Address | Washington Twp, MI 48095-2035 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2007 |
Last Update Date | 13/03/2019 |