Individual
MS. DIANNE ROSEBERRY JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1699 LEADENHALL STREET, SPRING GARDENS MEDICAL DISPENSARY, BALTIMORE, MD 21230
(410) 291-4800
(410) 291-4511
Mailing address
1699 LEADENHALL STREET, SPRING GARDENS MEDICAL DISPENSARY, BALTIMORE, MD 21230
(410) 291-4800
(410) 291-4511
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C0000147
MD
Other
Enumeration date
04/22/2008
Last updated
04/22/2008
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