Individual
MR. COSMO GORDON JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4001 LIBERTY HEIGHTS AVE, BALTIMORE, MD 21207-8053
(410) 578-1100
Mailing address
4001 LIBERTY HEIGHTS AVE, BALTIMORE, MD 21207-7545
(410) 578-1100
(410) 578-0596
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D21328
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
791251000
—
MD
Enumeration date
11/29/2005
Last updated
10/04/2010
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