Provider Demographics
NPI:1316150477
Name:JANOWSKI, WOJCIECH C (MD)
Entity type:Individual
Prefix:
First Name:WOJCIECH
Middle Name:C
Last Name:JANOWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 150627
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84415-0627
Mailing Address - Country:US
Mailing Address - Phone:385-492-4930
Mailing Address - Fax:385-492-4449
Practice Address - Street 1:5957 FASHION POINT DR STE 103
Practice Address - Street 2:
Practice Address - City:SOUTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-5180
Practice Address - Country:US
Practice Address - Phone:385-492-4930
Practice Address - Fax:385-492-4449
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-122322207R00000X
UT8650283207RC0200X
UT8650283-8905207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT8650283OtherUTAH LICENSE
IL036122322Medicaid
IL256510011Medicare PIN