Provider Demographics
NPI:1649265984
Name:JANET L SHILEY MD INC
Entity type:Organization
Organization Name:JANET L SHILEY MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SHILEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACS
Authorized Official - Phone:330-856-9960
Mailing Address - Street 1:983 NILES CORTLAND RD SE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-2538
Mailing Address - Country:US
Mailing Address - Phone:330-856-9960
Mailing Address - Fax:330-856-9981
Practice Address - Street 1:983 NILES CORTLAND RD SE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2538
Practice Address - Country:US
Practice Address - Phone:330-856-9960
Practice Address - Fax:330-856-9981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-13
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-06-0018174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0918127Medicaid
OH0918127Medicaid
OH9258281Medicare PIN