Provider Demographics
NPI:1548441975
Name:JAVANSHIR JANANI,M.D., P.C
Entity type:Organization
Organization Name:JAVANSHIR JANANI,M.D., P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAVANSHIR
Authorized Official - Middle Name:
Authorized Official - Last Name:JANANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-864-7100
Mailing Address - Street 1:PO BOX 59425
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20859-9425
Mailing Address - Country:US
Mailing Address - Phone:301-864-7100
Mailing Address - Fax:
Practice Address - Street 1:5632 ANNAPOLIS RD
Practice Address - Street 2:SUITE 4
Practice Address - City:BLADENSBURG
Practice Address - State:MD
Practice Address - Zip Code:20710-2213
Practice Address - Country:US
Practice Address - Phone:301-864-7100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0018630208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4531JOtherCAREFIRST BLUE SHIELD
DC0328OtherCAREFIRST BLUESHIELD
MD4531JOtherCAREFIRST BLUE SHIELD