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Individual
SIMON JACOBS
Active
Individual
SIMON JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
237357
MA
207R00000X
Internal Medicine Physician
25MA079874
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0096741
—
NJ
01
—
P00214923
MEDICARE RAIL ROAD
MA
01
—
P00342310
RR MEDICARE
NJ
Enumeration date
03/27/2006
Last updated
06/25/2014
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