Provider Demographics
NPI:1497774913
Name:JACOBS, RUTH MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:MARIE
Last Name:JACOBS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:935 BEACON SQUARE CT
Mailing Address - Street 2:# 38
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-5450
Mailing Address - Country:US
Mailing Address - Phone:301-216-1376
Mailing Address - Fax:301-309-0765
Practice Address - Street 1:9420 KEY WEST AVE
Practice Address - Street 2:#202
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3334
Practice Address - Country:US
Practice Address - Phone:301-315-9515
Practice Address - Fax:301-309-0765
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2011-08-11
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Provider Licenses
StateLicense IDTaxonomies
MDD29526207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD756621200Medicaid
MD69190001OtherBCBS
MD53201Medicare PIN
MD756621200Medicaid