Provider Demographics
NPI:1043624463
Name:JAKUBOWSKI, ROBERT ANSELMO (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ANSELMO
Last Name:JAKUBOWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:501 W 14TH ST FL 6
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-1013
Mailing Address - Country:US
Mailing Address - Phone:302-320-1300
Mailing Address - Fax:302-320-1373
Practice Address - Street 1:501 W 14TH ST FL 6
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-1013
Practice Address - Country:US
Practice Address - Phone:302-320-1300
Practice Address - Fax:302-320-1373
Is Sole Proprietor?:No
Enumeration Date:2014-06-13
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL37117207R00000X
DEC1-0025616207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine