Provider Demographics
NPI:1346223609
Name:FIELDS, JANICE M (MD)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:M
Last Name:FIELDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:M
Other - Last Name:SPEARS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30055 NORTHWESTERN HWY
Mailing Address - Street 2:STE 250
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3230
Mailing Address - Country:US
Mailing Address - Phone:248-985-5000
Mailing Address - Fax:248-985-5555
Practice Address - Street 1:30055 NORTHWESTERN HWY
Practice Address - Street 2:STE 250
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3230
Practice Address - Country:US
Practice Address - Phone:248-985-5000
Practice Address - Fax:248-985-5555
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301066213207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0M69450008Medicare ID - Type Unspecified
G78758Medicare UPIN