Janetzke, Ellen Amanda
Janetzke, Ellen Amanda is an sole proprietor health care provider with primary practice located at 60 W Big Beaver Rd Ste 100 , Bloomfield Hills MI 48304-3913. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Janetzke, Ellen Amanda can be contacted via phone (248) 258-5100.Contact Information
Primary practice address
60 W Big Beaver Rd Ste 100
Bloomfield Hills MI 48304-3913
Phone: (248) 258-5100
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 4301066875 | Michigan |
Profile Details
| NPI number | 1235120742 |
|---|---|
| LBN Legal business name | Janetzke, Ellen Amanda |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 3rd, 2005 |
| Last updated | May 20th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235120742 | NPPES |
| Michigan | MEDICAID | 4427695 | |
| Michigan | Other | 0634039 | |
| Michigan | Other | 7316280 |
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