Provider Demographics
NPI:1508861717
Name:MCDONALD, JANICE L (DO)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:L
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1847
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49443-1847
Mailing Address - Country:US
Mailing Address - Phone:231-727-4444
Mailing Address - Fax:231-727-4451
Practice Address - Street 1:1675 LEAHY ST
Practice Address - Street 2:SUITE 428
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-5500
Practice Address - Country:US
Practice Address - Phone:231-672-3300
Practice Address - Fax:231-672-3380
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MIJM008638207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI4161002OtherMEDICARE PTAN
MI433624011Medicaid
MIN27530074OtherMEDICARE
MIF07598Medicare UPIN