Organization
COVENANT FAMILY CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH S. JACOB MD (OWNER)
(248) 890-3603
Entity
Organization
Contact information
Practice address
33155 ANNAPOLIS ST, WAYNE, MI 48184-2405
(734) 593-7000
Mailing address
7432 RAFFORD LN, WEST BLOOMFIELD, MI 48322-3194
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/09/2008
Last updated
10/09/2008
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