Individual
DR. GRACE M JANIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2315 N LAKE DR, SUITE 501, MILWAUKEE, WI 53211-4518
(414) 289-9668
(414) 289-0498
Mailing address
2015 E NEWPORT AVE, SUITE 707, MILWAUKEE, WI 53211-2984
(414) 289-9668
(414) 289-0498
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
27674-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
391345728029
ANTHEM BLUE CROSS BLUE SH
WI
Enumeration date
09/25/2006
Last updated
11/13/2007
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