Individual
DR. JACOB T JOSEPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10721 MAIN ST, SUITE 1100, FAIRFAX, VA 22030-6914
(703) 273-4762
(703) 591-7719
Mailing address
10721 MAIN ST, SUITE 1100, FAIRFAX, VA 22030-6914
(703) 273-4762
(703) 591-7719
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
0101034461
VA
Other
Enumeration date
09/29/2006
Last updated
07/08/2007
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