Individual
SAM JACUBOWITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 N ELM ST, GREENSBORO, NC 27401-1004
(336) 716-2255
Mailing address
PO BOX 602598, WAKE FOREST UNIVERSITY HEALTH SCIENCES, CHARLOTTE, NC 28260-2598
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
93-00161
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39-01968
UHC
NC
01
—
4419
PARTNERS
NC
01
—
45709
NC BLUE CROSS BLUE SHIELD
NC
05
—
8945709
—
NC
Enumeration date
04/18/2006
Last updated
09/09/2011
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