Provider Demographics
NPI:1396963922
Name:JANNING, MARTIN HEINZ (MD)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:HEINZ
Last Name:JANNING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1801 19TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-4946
Mailing Address - Country:US
Mailing Address - Phone:320-231-3277
Mailing Address - Fax:320-214-5758
Practice Address - Street 1:1801 19TH AVE SW
Practice Address - Street 2:
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-4946
Practice Address - Country:US
Practice Address - Phone:320-231-3277
Practice Address - Fax:320-214-5758
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN40016207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP33842OtherHEALTH PARTNERS
MN313S2JAOtherMN BLUE SHIELD
MN268023800Medicaid
MNP00251507OtherRAILROAD MEDICARE
MN060120008OtherPRIMEWEST HEALTH SYSTEM
MN1852600OtherAMERICA'S PPO
MN20205327556201OtherCHAMPUS WEST REGION
MN29721OtherSIOUX VALLEY HEALTH PLAN
MNA13881023047OtherPREFERRED ONE
MN136689OtherUCARE OF MINNESOTA
MN1000690OtherMEDICA