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Individual

MIRIAM SARA JACOB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
9500 EUCLID AVE, J3-4, CLEVELAND, OH 44195-0001
(216) 444-4036
(216) 445-6192
Mailing address
9500 EUCLID AVE, J3-4, CLEVELAND, OH 44195-0001
(216) 444-4036
(216) 445-6192

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
35.121506
OH
207RC0000X
Cardiovascular Disease Physician
D72731
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
440701600
MD
01
974679-01
CAREFIRST BC/BS
MD
01
S062-0435
CAREFIRST BC/BS - REGIONAL
MD
Enumeration date
07/10/2006
Last updated
03/31/2015
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