Provider Demographics
NPI:1265517742
Name:JANUS, JENNIFER COX (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:COX
Last Name:JANUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12916 CONAMAR DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-2760
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12916 CONAMAR DRIVE
Practice Address - Street 2:SUITE 204
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742
Practice Address - Country:US
Practice Address - Phone:301-791-0600
Practice Address - Fax:301-791-0860
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV22396207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVP00354800OtherRAILROAD MEDICARE
WV3810006509Medicaid
WV3810006509Medicaid
I62850Medicare UPIN