Healthcare Provider Details

I. General information

NPI: 1659372233
Provider Name (Legal Business Name): JAN D SOLLI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 12/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 NORLAND AVE SUITE 207
CHAMBERSBURG PA
17201-4230
US

IV. Provider business mailing address

757 NORLAND AVE SUITE 207
CHAMBERSBURG PA
17201-4230
US

V. Phone/Fax

Practice location:
  • Phone: 717-217-6944
  • Fax: 717-217-6955
Mailing address:
  • Phone: 717-217-6944
  • Fax: 717-217-6955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD422418
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD422418
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: