Jacob, Sera L

Jacob, Sera L is an individual health care provider with primary practice located at 802 Green Valley Rd Suite 106, Greensboro NC 27408-7041. She recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as her primary health care specialty. Jacob, Sera L can be contacted via phone (336) 716-2255.

Contact Information

Primary practice address
802 Green Valley Rd Suite 106 Greensboro NC 27408-7041
Fax: (336) 716-9440
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 9600264 North Carolina

Profile Details

NPI number 1598710246
LBN Legal business name Jacob, Sera L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2006
Last updated Nov 18th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598710246 NPPES
North Carolina Other 1197J BCBS
North Carolina MEDICAID 891197J BCBS

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