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NPI Code Detail

MEDICARE: MARK E JANULEWICZ M.D.

MEDICARE: MARK E JANULEWICZ M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician13091NE

General Provider Information

NPI Number : 1760430623
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK E JANULEWICZ M.D.
Provider Business Mailing Address
First Line : 2201 N BROADWELL AVE
Second Line : GRAND ISLAND VA MEDICAL CENTER
City : GRAND ISLAND
State : NE
Zip : 68803-2196
Country : US
Telephone Number : 308-382-3660
Fax Number : 308-385-2702
Provider Business Practice Location Address
First Line : 2201 N BROADWELL AVE
Second Line : GRAND ISLAND VA MEDICAL CENTER
City : GRAND ISLAND
State : NE
Zip : 68803-2153
Country : US
Telephone Number : 308-382-3660
Fax Number : 308-385-2702
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 08/06/2015

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