Provider Demographics
NPI:1104197466
Name:HEAL, JARED KARTCHNER (DO, UMO/DMO USN)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:KARTCHNER
Last Name:HEAL
Suffix:
Gender:M
Credentials:DO, UMO/DMO USN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 BLAKE RD
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21402-1300
Mailing Address - Country:US
Mailing Address - Phone:710-293-1706
Mailing Address - Fax:
Practice Address - Street 1:121 BLAKE RD
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21402-1300
Practice Address - Country:US
Practice Address - Phone:710-293-1706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-19
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP61053446207P00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program