Healthcare Provider Details
I. General information
NPI: 1942249925
Provider Name (Legal Business Name): JANICE WERBINSKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 06/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7895 CURRIER DR
PORTAGE MI
49002-4314
US
IV. Provider business mailing address
5943 STADIUM DR STE 3
KALAMAZOO MI
49009-3016
US
V. Phone/Fax
- Phone: 269-321-7080
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 4301037450 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: