Individual
MR. MICHAEL CHARLES JANOWAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
888 THACKERAY TRL, STE 108, OCONOMOWOC, WI 53066-4342
(262) 567-0505
(262) 567-0778
Mailing address
888 THACKERAY TRL, STE 108, OCONOMOWOC, WI 53066
(262) 567-0505
(262) 567-0778
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
18235
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000102385
MEDICARE
WI
01
—
000168715
MEDICARE
WI
01
—
040004256
RAILROAD MEDICARE
WI
01
—
1004201
PHYSICIANS PLUS
WI
05
—
30102900
—
WI
01
—
777
DEAN HEALTH PLAN
WI
Enumeration date
03/01/2006
Last updated
01/28/2013
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