Individual
JACOB GEORGE EIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(800) 653-6568
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
4301507506
MI
207Y00000X
Otolaryngology Physician
Primary
76746
MN
207Y00000X
Otolaryngology Physician
MD473590
PA
Other
Enumeration date
04/08/2016
Last updated
04/15/2024
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