Individual
DR. JONATHAN JAY MUSMAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
195 FORE RIVER PKWY, SUITE 410, PORTLAND, ME 04102-2780
(207) 774-9839
(207) 761-2127
Mailing address
195 FORE RIVER PKWY, SUITE 410, PORTLAND, ME 04102
(207) 774-9839
(207) 761-2127
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
013825
ME
207K00000X
Allergy & Immunology Physician
Primary
013825
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110740000
—
ME
Enumeration date
05/04/2006
Last updated
01/13/2015
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