Provider Demographics
NPI:1609929421
Name:WARNER, JANET GRAY (MD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:GRAY
Last Name:WARNER
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 1:1101 W UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1863
Mailing Address - Country:US
Mailing Address - Phone:248-652-5291
Mailing Address - Fax:248-652-5817
Practice Address - Street 1:1101 W. UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1831
Practice Address - Country:US
Practice Address - Phone:248-652-5291
Practice Address - Fax:248-652-5217
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010618442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIJW061844OtherBCBSM
MI10 4646501Medicaid
MIG99225Medicare UPIN
MI10 4646501Medicaid