Individual
DR. MICHAEL JOHN JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
26850 PROVIDENCE PKWY, SUITE 504, NOVI, MI 48374-1213
(248) 662-4333
(248) 662-3022
Mailing address
26850 PROVIDENCE PKWY, SUITE 504, NOVI, MI 48374-1213
(248) 662-4333
(248) 662-3022
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MJ068638
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4569968
—
MI
Enumeration date
08/12/2006
Last updated
06/09/2020
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