Provider Demographics
NPI:1639114036
Name:JACOB, KARIM H (MD)
Entity Type:Individual
Prefix:DR
First Name:KARIM
Middle Name:H
Last Name:JACOB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2158 INTELLIPLEX DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46176-8548
Mailing Address - Country:US
Mailing Address - Phone:317-392-3651
Mailing Address - Fax:317-398-0538
Practice Address - Street 1:2158 INTELLIPLEX DR
Practice Address - Street 2:SUITE 200
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-8548
Practice Address - Country:US
Practice Address - Phone:317-392-3651
Practice Address - Fax:317-398-0538
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH14333207R00000X, 174400000X
IN01072219A207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine