Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | MD019241E | PA |
NPI | 1114944758 |
---|---|
Provider Name | Fred H Rubin |
First Address | Pittsburgh, PA 15232 |
Second Address | Pittsburgh, PA 15232 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 11/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0011057220 | (05) | PA |
473855 | HIGHMARK BCBS (01) | PA |
B72539 | (02) |