Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | MD426361 | PA |
N | 207ND0900X | Dermatopathologist | MD426361 | PA |
NPI | 1104927078 |
---|---|
Provider Name | Dr. Adam Ian Rubin |
First Address | Philadelphia, PA 19104-4306 |
Second Address | Philadelphia, PA 19104-4306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 02/04/2012 |