Individual
DR. MARK EDWARD JACOBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2900 BRADFORD ST NE, GRAND RAPIDS, MI 49525-6427
(616) 885-5000
(616) 486-6702
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
13067
NH
207RI0011X
Interventional Cardiology Physician
Primary
4301080162
MI
Other
Enumeration date
05/15/2006
Last updated
02/17/2021
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