Provider Demographics
NPI:1003631052
Name:JANEGA, WILLIAM M (NC HIS #1458)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:M
Last Name:JANEGA
Suffix:
Gender:M
Credentials:NC HIS #1458
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 JACKSONS RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-4500
Mailing Address - Country:US
Mailing Address - Phone:910-336-1673
Mailing Address - Fax:
Practice Address - Street 1:SAMS CLUB HEARING AID CENTER
Practice Address - Street 2:412 S. COLLEGE RD
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403
Practice Address - Country:US
Practice Address - Phone:910-338-9049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-15
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1458237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist