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Individual

ZACHARY JAKUBIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
2520 E DUPONT RD, FORT WAYNE, IN 46825-1675
(260) 416-3000
Mailing address
1909 GARDENIA AVE APT 4, ROYAL OAK, MI 48067-2130
(586) 557-5036

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
02006550B
IN
207P00000X
Emergency Medicine Physician
Primary
5101024601
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0045751
OH
Enumeration date
06/14/2018
Last updated
07/17/2024
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