Healthcare Provider Details
I. General information
NPI: 1720012214
Provider Name (Legal Business Name): JANINE P WINTERS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/10/2006
Last Update Date: 04/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
555 S 18TH ST
COLUMBUS OH
43205-2654
US
IV. Provider business mailing address
555 S 18TH ST
COLUMBUS OH
43205-2654
US
V. Phone/Fax
- Phone: 614-722-4950
- Fax: 614-722-4966
- Phone: 614-722-4950
- Fax: 614-722-4966
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 35070008 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080H0002X |
| Taxonomy | Pediatric Hospice and Palliative Medicine Physician |
| License Number | 35070008 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: