Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | D0071130 | MD |
N | 207R00000X | Internist | D0071130 | MD |
N | 111NI0900X | Internist | D0071130 | MD |
NPI | 1104952308 |
---|---|
Provider Name | Keri N. Jacobs |
First Address | Chestertown, MD 21620-1435 |
Second Address | Chestertown, MD 21620-1435 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2007 |
Last Update Date | 29/11/2021 |