Provider Demographics
NPI:1891808861
Name:DAVIS, JANAE M (MD)
Entity Type:Individual
Prefix:
First Name:JANAE
Middle Name:M
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:JANAE
Other - Middle Name:M
Other - Last Name:PAIGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:20 W LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-5520
Mailing Address - Country:US
Mailing Address - Phone:220-564-7940
Mailing Address - Fax:220-564-7941
Practice Address - Street 1:20 W LOCUST ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-5520
Practice Address - Country:US
Practice Address - Phone:220-564-7940
Practice Address - Fax:220-564-7941
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35085698207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2676171Medicaid
OH2676171Medicaid