Provider Demographics
NPI:1932181294
Name:JANUSZIEWICZ, ALAN ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:ANDREW
Last Name:JANUSZIEWICZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16053 KINGS MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-4531
Mailing Address - Country:US
Mailing Address - Phone:706-580-0735
Mailing Address - Fax:
Practice Address - Street 1:16053 KINGS MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-4531
Practice Address - Country:US
Practice Address - Phone:703-580-0735
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD041526E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine