Provider Demographics
NPI:1164530879
Name:DRAZDIK, JANEEN M (MD)
Entity Type:Individual
Prefix:DR
First Name:JANEEN
Middle Name:M
Last Name:DRAZDIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7225 OLD OAK BLVD
Mailing Address - Street 2:SUITE 210A
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3339
Mailing Address - Country:US
Mailing Address - Phone:440-816-2761
Mailing Address - Fax:440-816-8065
Practice Address - Street 1:7225 OLD OAK BLVD
Practice Address - Street 2:SUITE 210A
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3339
Practice Address - Country:US
Practice Address - Phone:440-816-2761
Practice Address - Fax:440-816-8065
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35074152207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2180072Medicaid
OH2180072Medicaid
OH7301091Medicare PIN