Provider Demographics
NPI:1023234200
Name:ROMANIK, JANIS ELIZABETH (DO)
Entity type:Individual
Prefix:DR
First Name:JANIS
Middle Name:ELIZABETH
Last Name:ROMANIK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:400 STODDARD RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:MI
Mailing Address - Zip Code:48062-2505
Mailing Address - Country:US
Mailing Address - Phone:248-658-1116
Mailing Address - Fax:248-658-1120
Practice Address - Street 1:12150 30 MILE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:WASHINGTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48095-2035
Practice Address - Country:US
Practice Address - Phone:586-336-2380
Practice Address - Fax:586-336-2381
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101016195207Q00000X, 208D00000X, 207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice