Individual
MARIA JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
227 SAINT PAUL PL, LOWER LEVEL, BALTIMORE, MD 21202-2001
(410) 332-9055
(410) 576-5288
Mailing address
PO BOX 824173, PHILADELPHIA, PA 19182-4173
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
D0020938
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
321731100
—
MD
01
—
G010 / 0001
BLUECHOICE
MD
01
—
KDA7 / 617127-01
BC / BS OF MD
MD
Enumeration date
05/20/2006
Last updated
07/01/2013
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