Doctor Name: | DR. GEORGE ADAM JAKUBEK |
NPI Number: | 1982867644 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.O. |
License Number: | 0102202439 |
Business Practice Address: | 8901 Wisonsin Ave Bethesda, MD - 208895600 |
Business Phone Number: | 3012954770 |
Business Fax Number: | 3012954759 |
Mailing Address: | 5800 Hannora Ln, FAIRFAX STATION |
State: | VA |
Postal Code: | 220391428 |
Phone Number: | 7034701104 |
Fax Number: | |
NPI Enumeration Date: | 07/03/2008 |
NPI Last Update Date: | 11/29/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 0102202439 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |