Individual
JANICE M. DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AA
Contact information
Practice address
3714 GUARDIAN AVE STE W, MOREHEAD CITY, NC 28557-2975
(252) 648-0409
Mailing address
411 EMERALD LANDING DR, EMERALD ISLE, NC 28594-2407
(440) 289-5253
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
1000-00835
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000232159
UNISON
OH
01
—
000000515963
ANTHEM
OH
01
—
0583328
BCMH
OH
05
—
2268264
—
OH
01
—
414964
WELLCARE MEDICAID
OH
01
—
430027428
RAILROAD MEDICARE
OH
01
—
7758969
AETNA
OH
Enumeration date
07/24/2006
Last updated
07/29/2021
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