Individual
ANNE USHA JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.B.B.S.
Contact information
Practice address
3649 PAGE BLVD, SAINT LOUIS, MO 63113-3807
(314) 288-0071
(314) 758-5210
Mailing address
3649 PAGE BLVD, SAINT LOUIS, MO 63113-3807
(314) 288-0071
(314) 758-5210
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2015008169
MO
207Q00000X
Family Medicine Physician
42911
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
350431000
—
MN
Enumeration date
10/10/2005
Last updated
03/05/2021
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