Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | D91262 | MD |
Y | 2081P2900X | Pain Medicine | D91262 | MD |
NPI | 1093178386 |
---|---|
Provider Name | David Kerwin Jacobs |
First Address | Baltimore, MD 21202-2123 |
Second Address | Baltimore, MD 21202-2123 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2016 |
Last Update Date | 14/05/2021 |