Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | MD017709E | PA |
NPI | 1073584272 |
---|---|
Provider Name | Samuel A Jacobs |
First Address | Pittsburgh, PA 15232-1301 |
Second Address | Pittsburgh, PA 15232-1301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 13/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C28919 | (02) | PA |