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Individual

ERIC MICHAEL JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
600 N WOLFE ST, PHIPPS 571, BALTIMORE, MD 21287-0005
(410) 955-7171
(410) 955-0626
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 955-0626

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
239160
MA
207T00000X
Neurological Surgery Physician
35095700
OH
207T00000X
Neurological Surgery Physician
Primary
D0076696
MD
207T00000X
Neurological Surgery Physician
MD424942
PA

Other

Enumeration date
12/18/2006
Last updated
09/26/2022
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