Individual
SAMUEL JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2525 W UNIVERSITY AVE STE 300, MUNCIE, IN 47303-3432
(765) 747-3883
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
01079242A
IN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
2018005840
MO
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
ME131137
FL
Other
Enumeration date
06/10/2009
Last updated
11/15/2023
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