Individual
JANA UPSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
18649
SC
208000000X
Pediatrics Physician
2010-01542
NC
2080S0010X
Pediatric Sports Medicine Physician
18649
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
186499
—
SC
Enumeration date
08/29/2006
Last updated
03/11/2020
Update your record
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