Organization
JONATHAN HERLAND D SC MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN S HERLAND (OWNER)
(855) 927-7246
Entity
Organization
Contact information
Practice address
163 VAN BUREN RD, CARIBOU, ME 04736-3567
(855) 927-7246
Mailing address
198 HIGH ST, CARIBOU, ME 04736-1836
(855) 927-7246
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
015192
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
039403
ANTHEM
ME
05
—
155430000
—
ME
01
—
7014011
AETNA
ME
Enumeration date
10/18/2006
Last updated
03/17/2018
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