Provider Demographics
NPI:1073503785
Name:STORELLA, JANET M (MD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:M
Last Name:STORELLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 4196
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31914-0196
Mailing Address - Country:US
Mailing Address - Phone:706-653-1102
Mailing Address - Fax:706-653-1230
Practice Address - Street 1:1145 19TH ST NW
Practice Address - Street 2:SUITE 205
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-3701
Practice Address - Country:US
Practice Address - Phone:301-279-4499
Practice Address - Fax:301-279-4489
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD00384112085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A56862Medicare UPIN
590468G23Medicare UPIN