Provider Demographics
NPI:1447294749
Name:JANANI, JAVANSHIR (MD)
Entity type:Individual
Prefix:
First Name:JAVANSHIR
Middle Name:
Last Name:JANANI
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:PO BOX 59425
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20859-9425
Mailing Address - Country:US
Mailing Address - Phone:301-864-7100
Mailing Address - Fax:301-277-4495
Practice Address - Street 1:5632 ANNAPOLIS RD
Practice Address - Street 2:SUITE 4
Practice Address - City:BLADENSBURG
Practice Address - State:MD
Practice Address - Zip Code:20710-2213
Practice Address - Country:US
Practice Address - Phone:301-864-7100
Practice Address - Fax:301-277-4495
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0018630208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1800346OtherAMERICHOICE INC.
MD4531JOtherCAREFIRST BLUESHIELD
DC0328-0001OtherCAREFIRST BLUE SHIELD
MD05410OtherAMERIGROUP, INC.
MD501377OtherNC PPO INC
DCC61586Medicare UPIN
MD05410OtherAMERIGROUP, INC.