Individual
DR. LOUIS BERNARD JACQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7500 SECURITY BLVD, MAILSTOP C1-09-06, BALTIMORE, MD 21244-1849
(410) 786-4512
(410) 786-9286
Mailing address
918 BARRACUDA COVE CT, ANNAPOLIS, MD 21401-4719
(410) 349-1730
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101042011
VA
207Q00000X
Family Medicine Physician
Primary
D0036186
MD
207Q00000X
Family Medicine Physician
MD14879
DC
Other
Enumeration date
06/30/2005
Last updated
11/12/2008
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