Provider Demographics
NPI:1831293307
Name:SMOLEC, JANICE ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:ANN
Last Name:SMOLEC
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 1:98-211 PALI MOMI ST
Mailing Address - Street 2:SUITE 800
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4301
Mailing Address - Country:US
Mailing Address - Phone:808-487-1559
Mailing Address - Fax:808-486-6485
Practice Address - Street 1:98-211 PALI MOMI ST
Practice Address - Street 2:SUITE 800
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4301
Practice Address - Country:US
Practice Address - Phone:808-487-1559
Practice Address - Fax:808-486-6485
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3348174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI03910401Medicaid