CHRIS JACOB DO NPI 1790163962

NPI Information

NPI: 1790163962
Provider Name: CHRIS JACOB, DO
Classification: Student in an Organized Health Care Education/Training Program - 390200000X
Entity Type: Individual
Address:
24211 LITTLE MACK AVE
SAINT CLAIR SHORES, MI
ZIP 48080
Phone: (586) 498-0440
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Chris Jacob, DO is a student in an organized health care education training program in Saint Clair Shores, MI. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Chris Jacob, DO NPI is 1790163962. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

24211 LITTLE MACK AVE
SAINT CLAIR SHORES, MI
ZIP 48080-151
Phone: (586) 498-0440
Fax: (586) 498-0401

The enumeration date for this NPI number is 5/8/2015 and was last updated on 6/29/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	License State	Primary
1	207R00000X	Internal Medicine	5101021621	MICHIGAN	No
2	208M00000X	Hospitalist	293779	NEW YORK	No
3	390200000X	Student in an Organized Health Care Education/Training Program	5151009894	MICHIGAN	Yes
4	390200000X	Student in an Organized Health Care Education/Training Program	5101021621	MICHIGAN	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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