DR. Glen Mirandilla Jacob, MD

NPI #1780757062 in Largo, Maryland

Provider Information

NPI Number: 1780757062
Entity Type: Individual
Name: DR. Glen Mirandilla Jacob, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Internal Medicine
Credential: MD
Enumeration Date: Nov 16, 2006
Last Updated: Feb 23, 2022

Practice Location

Address: 1221 MERCANTILE LANE
City: Largo
State: Maryland
ZIP Code: 20774-5374
Phone: (301) 618-5578

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary
Internal Medicine - Geriatric Medicine — Geriatric Medicine	207RG0300X

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