Individual
DR. HARRY SAMUEL JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
424 HARVARD STREET SE, FIRST FLOOR, SUITE M100, UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455
(612) 625-5411
Mailing address
420 DELAWARE STREET SE, MMC 480, UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455
(612) 624-0123
(612) 624-0123
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A94067
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04-75091
MEDICA PRIMARY
MN
01
—
1009156
PREFERRED ONE
MN
01
—
101279
UCARE
MN
01
—
30-00036
MEDICA CHOICE
MN
01
—
604593
ARAZ
MN
01
—
HP22077
HEALTHPARTNERS
MN
Enumeration date
07/24/2006
Last updated
07/09/2007
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