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Individual

DR. MICHAEL A JACOBSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1051 LONG RIDGE RD, STAMFORD, CT 06903-4436
(203) 329-7960
(203) 329-7920
Mailing address
1051 LONG RIDGE RD, STAMFORD, CT 06903-4436
(203) 329-7960
(203) 329-7920

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
LL27743
SC
207N00000X
Dermatology Physician
Primary
MD434064
PA
207ND0101X
MOHS-Micrographic Surgery Physician
047462
CT
207ND0101X
MOHS-Micrographic Surgery Physician
260244-1
NY

Other

Enumeration date
10/19/2006
Last updated
01/18/2017
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