Provider Demographics
NPI:1457356024
Name:WHELAN, JANET C (OD, PA)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:C
Last Name:WHELAN
Suffix:
Gender:F
Credentials:OD, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 BEACON AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-2917
Mailing Address - Country:US
Mailing Address - Phone:207-284-4231
Mailing Address - Fax:207-283-4234
Practice Address - Street 1:3 BEACON AVE
Practice Address - Street 2:STE 101
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-2917
Practice Address - Country:US
Practice Address - Phone:207-284-4231
Practice Address - Fax:207-283-4234
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOPT715152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME000654OtherANTHEM BCBS
ME1041325OtherAETNA
ME238760099Medicaid
ME000654OtherANTHEM BCBS
ME1041325OtherAETNA
MEU32736Medicare UPIN
ME410039947Medicare PIN