Provider Demographics
NPI:1417075813
Name:CROOK, JANET UHLAN (MD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:UHLAN
Last Name:CROOK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:LEE
Other - Last Name:UHLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1382 CHALMERS CT NW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-7741
Mailing Address - Country:US
Mailing Address - Phone:980-255-9822
Mailing Address - Fax:
Practice Address - Street 1:7845 LITTLE AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-8198
Practice Address - Country:US
Practice Address - Phone:704-375-0100
Practice Address - Fax:704-335-3592
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33571207Q00000X, 207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8984454Medicaid
NC84454OtherBLUE CROSS BLUE SHIELD
E40888Medicare UPIN
NC2210661GMedicare PIN