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Individual

MARY ANNE JACOB

Active
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Individual

MARY ANNE JACOB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
41934
MN
207VE0102X
Reproductive Endocrinology Physician
41934
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11D21JA
BLUE CROSS/BLUE SHIELD
MN
05
—
252025700
—
MN
01
—
HP29251
HEALTH PARTNERS
MN
Enumeration date
03/01/2006
Last updated
04/04/2016
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