Provider Demographics
NPI:1952810947
Name:JACOBS, DAWN ANITA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:ANITA
Last Name:JACOBS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5525 EASTERN AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-2796
Mailing Address - Country:US
Mailing Address - Phone:443-703-3655
Mailing Address - Fax:443-703-3639
Practice Address - Street 1:3501 SINCLAIR LN
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-2029
Practice Address - Country:US
Practice Address - Phone:443-703-3654
Practice Address - Fax:443-703-3639
Is Sole Proprietor?:No
Enumeration Date:2017-09-22
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15066183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist