Individual
MICHAEL JANICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
408 N HANCOCK AVE, ODESSA, TX 79761-5140
(432) 580-7373
(432) 580-3275
Mailing address
6245 INKSTER RD, GARDEN CITY, MI 48135-4001
(734) 458-4486
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
5101021147
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
TX
Enumeration date
07/01/2014
Last updated
11/14/2019
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