Individual
RYAN WAYNE JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1021 MOREHEAD MEDICAL DR, STE A, CHARLOTTE, NC 28204-2990
(980) 442-2000
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2015-00694
NC
207RH0000X
Hematology (Internal Medicine) Physician
Primary
2015-00694
NC
207RX0202X
Medical Oncology Physician
2015-00694
NC
Other
Enumeration date
04/08/2009
Last updated
07/15/2024
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