Individual
DR. JACOB BABU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1104 E GRACE ST, RENSSELAER, IN 47978-3211
(219) 866-5141
(219) 866-3234
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01069089A
IN
208M00000X
Hospitalist Physician
Primary
01069089A
IN
208M00000X
Hospitalist Physician
01069089B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201128490
—
IN
Enumeration date
02/01/2009
Last updated
02/17/2023
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