Jacobs, Lisa

Jacobs, Lisa is an individual health care provider with primary practice located at 4940 Eastern Ave , Baltimore MD 21224-2735. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgical Oncology, which is considered as her primary health care specialty. Jacobs, Lisa can be contacted via phone (410) 550-0400.

Contact Information

Primary practice address
4940 Eastern Ave Baltimore MD 21224-2735
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgical Oncology 2086X0206X D61193 Maryland

Profile Details

NPI number 1063451714
LBN Legal business name Jacobs, Lisa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2006
Last updated Feb 8th, 2013 - about 11 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 1063451714 NPPES
Maryland MEDICAID 404182800

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