Provider Demographics
NPI:1184677668
Name:NAUMANN, JANICE STELLJES (MD)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:STELLJES
Last Name:NAUMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JANICE
Other - Middle Name:REGINA
Other - Last Name:STELLJES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-333-4104
Mailing Address - Fax:704-358-4544
Practice Address - Street 1:2711 RANDOLPH RD
Practice Address - Street 2:SUITE 512
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-2034
Practice Address - Country:US
Practice Address - Phone:704-333-4104
Practice Address - Fax:704-358-4544
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2020-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9601137207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891084CMedicaid
NC2280536Medicare PIN
NC891084CMedicaid
F26303Medicare UPIN