Individual
DR. MICHELLE CHRISTINE JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1375 E 19TH AVE, DENVER, CO 80218-1114
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
(303) 338-4545
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301084104
MI
208000000X
Pediatrics Physician
Primary
50503
CO
2080P0203X
Pediatric Critical Care Medicine Physician
4301084104
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022197
KAISER COMMERCIAL NUMBER
CO
05
—
02528517
—
CO
01
—
1417961137
BCBSM - BRONSON
MI
05
—
1639387848
—
MI
Enumeration date
05/19/2007
Last updated
06/11/2021
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