Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 22042 | NC |
NPI | 1033223938 |
---|---|
Provider Name | Michael Hotelling Rubin |
First Address | Winston Salem, NC 27103-4047 |
Second Address | Winston Salem, NC 27103-4047 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2901101 | UNITEDHEALTHCARE (01) | |
73825 | BLUE CROSS BLUE SHIELD (01) | |
89-73825 | (05) | NC |
C86236 | (02) |