Provider Demographics
NPI:1659372233
Name:SOLLI, JAN D (MD)
Entity Type:Individual
Prefix:
First Name:JAN
Middle Name:D
Last Name:SOLLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:757 NORLAND AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4230
Mailing Address - Country:US
Mailing Address - Phone:717-217-6944
Mailing Address - Fax:717-217-6955
Practice Address - Street 1:757 NORLAND AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-4230
Practice Address - Country:US
Practice Address - Phone:717-217-6944
Practice Address - Fax:717-217-6955
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD422418174400000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00278952OtherMEDICARE RAILROAD
PA001974948 0001Medicaid
P00278952OtherMEDICARE RAILROAD
PA001974948 0001Medicaid
PAH98833Medicare UPIN