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Individual

EDUARDO JACOBS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
42301 MOUND RD, STERLING HEIGHTS, MI 48314-3148
(586) 557-4441
Mailing address
PO BOX 1465, WARREN, MI 48090-1465
(586) 557-4441

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
4301097822
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
802322652
LARA
MI
Enumeration date
09/17/2019
Last updated
09/17/2019
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