Individual
DR. TINA JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4924 CAMPBELL BLVD, NOTTINGHAM, MD 21236-5908
(410) 955-5000
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(806) 743-6130
(806) 743-3955
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0098428
MD
Other
Enumeration date
05/27/2020
Last updated
12/15/2023
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