Individual
JERROLD OLSHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
887 CONGRESS ST, SUITE 320, PORTLAND, ME 04102-3100
(207) 662-5522
(207) 662-5527
Mailing address
301 US ROUTE 1, SCARBOROUGH, ME 04074-7609
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
013155
ME
2080P0205X
Pediatric Endocrinology Physician
Primary
013155
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30008631
—
NH
05
—
322340099
—
ME
Enumeration date
07/02/2006
Last updated
11/26/2014
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