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General NPI Number Information
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NPI Number | 1558449538
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Entity Type | Individual
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Provider Name | JAN ANDRIES HERHOLDT MD
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 600 HIGHLAND AVE
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City | MADISON
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State | WI
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Zip | 53792-4294
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Country | US
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Telephone | 608-263-8100
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Fax | 608-262-6247
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Provider Business Mailing Address
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Address Line | 181 SETTINGS BLVD
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City | BLACK MOUNTAIN
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State | NC
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Zip | 28711-8835
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | V6183
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 419222
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 82470
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License Number State | WI
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