Individual
DR. JAAN E. SIDOROV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
413 VILLAGE WAY, HARRISBURG, PA 17112-8849
(717) 566-6287
(717) 566-6310
Mailing address
413 VILLAGE WAY, HARRISBURG, PA 17112-8849
(717) 566-6287
(717) 566-6310
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD032760E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001007329
—
PA
Enumeration date
05/02/2006
Last updated
02/08/2008
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