Individual
PRIYANKA JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7106 RIDGE RD STE B, BALTIMORE, MD 21237-3883
(410) 687-2300
Mailing address
PO BOX 13579, READING, PA 19612-3579
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D014109
MD
207Q00000X
Family Medicine Physician
MT227006
PA
Other
Enumeration date
07/26/2022
Last updated
06/17/2025
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