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
Phone: (410) 550-0400
Fax:
Website:
Health care specialties
Specialty | Code | License # | 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 12 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1063451714 | NPPES |
Maryland | MEDICAID | 404182800 |
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