Provider Demographics
NPI:1699767608
Name:HELD, JONATHAN L (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:L
Last Name:HELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 BURROUGHS RD
Mailing Address - Street 2:
Mailing Address - City:BOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:01719-1916
Mailing Address - Country:US
Mailing Address - Phone:978-263-7175
Mailing Address - Fax:
Practice Address - Street 1:190 GROTON RD
Practice Address - Street 2:SUITE 180
Practice Address - City:AYER
Practice Address - State:MA
Practice Address - Zip Code:01432-1124
Practice Address - Country:US
Practice Address - Phone:978-772-7221
Practice Address - Fax:978-772-5849
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA60554174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAE03208Medicare UPIN