Individual
JACOB DEAN MCAULIFFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8081 INNOVATION PARK DR # 700, FAIRFAX, VA 22031-4867
(703) 776-3582
Mailing address
8081 INNOVATION PARK DR # 700, FAIRFAX, VA 22031-4867
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101278788
VA
207RC0000X
Cardiovascular Disease Physician
0101278788
VA
Other
Enumeration date
04/10/2020
Last updated
07/01/2024
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