Individual
JASON A LACHANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
102 CAMPUS DR, SCARBOROUGH, ME 04074-9692
(207) 883-0069
(207) 883-0999
Mailing address
301C US ROUTE 1, SCARBOROUGH, ME 04074-9701
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
MD12732
RI
207VX0201X
Gynecologic Oncology Physician
Primary
MD18183
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30208744
—
NH
05
—
434243299
—
ME
Enumeration date
05/02/2007
Last updated
03/06/2012
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