MEDICARE: MR. RONALD D. JACOBS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	D0032150	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	D0032150	OTHER	MD	MEDICAL LICENSE

General Provider Information

NPI Number	:	1558358853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RONALD D. JACOBS M.D.

Provider Business Mailing Address
First Line	:	8110 MAPLE LAWN BLVD STE 235
Second Line	:
City	:	FULTON
State	:	MD
Zip	:	20759-2694
Country	:	US
Telephone Number	:	301-340-8339
Fax Number	:	301-340-9027

Provider Business Practice Location Address
First Line	:	2101 MEDICAL PARK DR
Second Line	:	SUITE #200E
City	:	SILVER SPRING
State	:	MD
Zip	:	20902-4053
Country	:	US
Telephone Number	:	301-468-0073
Fax Number	:	240-283-8412

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2005
Last Update Date	:	10/30/2023

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Directions to “ MR. RONALD D. JACOBS M.D.” Practice Location

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