Sidorov, Jaan E.
Sidorov, Jaan E. is an sole proprietor health care provider with primary practice located at 413 Village Way , Harrisburg PA 17112-8849. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Sidorov, Jaan E. can be contacted via phone (717) 566-6287.Contact Information
Primary practice address
413 Village Way
Harrisburg PA 17112-8849
Phone: (717) 566-6287
Fax: (717) 566-6310
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD032760E | Pennsylvania |
Profile Details
| NPI number | 1114985066 |
|---|---|
| LBN Legal business name | Sidorov, Jaan E. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 2nd, 2006 |
| Last updated | Feb 8th, 2008 - about 18 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 | 1114985066 | NPPES |
| Pennsylvania | MEDICAID | 001007329 |
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