Individual
DR. STEPHEN P JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6701 N CHARLES ST, TOWSON, MD 21204-6808
(410) 296-4616
(410) 337-5068
Mailing address
230 SCHILLING CIRCLE #170, ATTN: MARY ELLEN CUTHIE, HUNT VALLEY, MD 21031-1417
(410) 296-4616
(410) 337-5068
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
D0043060
MD
207LP2900X
Pain Medicine (Anesthesiology) Physician
D0043060
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
752591500
—
MD
01
—
D0043060
STATE LICENSE NUMBER
MD
Enumeration date
08/09/2005
Last updated
10/30/2019
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