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Individual

DR. JACOB FREDRICK COLLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5255 LOUGHBORO RD NW, WASHINGTON, DC 20016-2633
(410) 955-5000
Mailing address
6201 GREENLEIGH AVE, BALTIMORE, MD 21220-2004
(240) 439-8812

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
MD500002488
DC
207RP1001X
Pulmonary Disease Physician
D79963
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
D79963
MARYLAND STATE MEDICAL LICENSE
MD
Enumeration date
09/15/2006
Last updated
03/19/2025
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