Provider Demographics
NPI:1033149299
Name:JOBE, DANIEL BRIAN (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:BRIAN
Last Name:JOBE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1226 EASTCHESTER DR STE 200
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-3116
Practice Address - Country:US
Practice Address - Phone:336-481-8610
Practice Address - Fax:336-481-8619
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9401423207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC110166989OtherRAILROAD MEDICARE
NC8946037Medicaid
NCG25844Medicare UPIN
NC2222550Medicare PIN
G25844Medicare UPIN
2222550Medicare ID - Type Unspecified