Individual
DR. JOHN DOROMAL JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
834 WALNUT ST STE 650, PHILADELPHIA, PA 19107-5109
(215) 955-6996
(215) 923-6003
Mailing address
1245 HIGHLAND AVE BLDG SUITE401, ABINGTON, PA 19001-3714
(215) 481-6070
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD454429
PA
2086S0102X
Surgical Critical Care Physician
308671
NY
2086S0102X
Surgical Critical Care Physician
MD454429
PA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
308671
NY
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD454429
PA
Other
Enumeration date
06/21/2011
Last updated
11/27/2023
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