Provider Demographics
NPI:1285683631
Name:MORIN-SIMS, JANETTE M (MD)
Entity Type:Individual
Prefix:DR
First Name:JANETTE
Middle Name:M
Last Name:MORIN-SIMS
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 1:4735 WEST RIVER DR.
Mailing Address - Street 2:
Mailing Address - City:COMSTOCK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:49321-9607
Mailing Address - Country:US
Mailing Address - Phone:616-784-9400
Mailing Address - Fax:616-784-5167
Practice Address - Street 1:4735 WEST RIVER DR.
Practice Address - Street 2:
Practice Address - City:COMSTOCK PARK
Practice Address - State:MI
Practice Address - Zip Code:49321-9607
Practice Address - Country:US
Practice Address - Phone:616-784-9400
Practice Address - Fax:616-784-5167
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301059685208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3175708Medicaid
MI059685Medicare UPIN