Healthcare Provider Details

I. General information

NPI: 1083752471
Provider Name (Legal Business Name): ARMANDO JANEIRA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 STONEWALL ST
CARTERSVILLE GA
30120-3628
US

IV. Provider business mailing address

1900 SHELBURNE CV
MARIETTA GA
30068-1524
US

V. Phone/Fax

Practice location:
  • Phone: 770-386-1907
  • Fax: 770-386-7345
Mailing address:
  • Phone: 770-846-1826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LA0401X
TaxonomyAddiction Medicine (Anesthesiology) Physician
License Number56463
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number56463
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: