Individual
LAITH J JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MBCHB
Contact information
Practice address
15645 FARMINGTON RD, LIVONIA, MI 48154-2851
(248) 245-6533
Mailing address
15645 FARMINGTON RD, LIVONIA, MI 48154-2851
(248) 245-6533
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301109743
MI
Other
Enumeration date
06/21/2016
Last updated
06/02/2025
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