Provider Demographics
NPI:1790848463
Name:ROLAND, JASON CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:CHARLES
Last Name:ROLAND
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5601 LOCH RAVEN BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-2905
Mailing Address - Country:US
Mailing Address - Phone:410-323-9210
Mailing Address - Fax:410-323-9525
Practice Address - Street 1:5601 LOCH RAVEN BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21239-2905
Practice Address - Country:US
Practice Address - Phone:410-323-9210
Practice Address - Fax:410-323-9525
Is Sole Proprietor?:No
Enumeration Date:2006-12-17
Last Update Date:2022-01-08
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Provider Licenses
StateLicense IDTaxonomies
DCMD034910208600000X
OH35089496208600000X
MDD0062094208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery