Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 0101043630 | VA |
N | 207YS0123X | Facial Plastic Surgeon | 0101043630 | VA |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 010143630 | VA |
NPI | 1003871971 |
---|---|
Provider Name | Dr. Mark I Rubinstein |
First Address | Fairfax, VA 22031-5207 |
Second Address | Fairfax, VA 22031-5207 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2006 |
Last Update Date | 06/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0005 | CAREFIRST ID (01) | |
006524141 | (05) | VA |
0101043630 | LICENSE # (01) | VA |
E22128 | (02) |