Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 234970 | MA |
Y | 2080P0210X | Pediatric Nephrologist | D80718 | MD |
N | 2080P0210X | Pediatric Nephrologist | MD436618 | PA |
NPI | 1972776367 |
---|---|
Provider Name | Rebecca Lynn Ruebner |
First Address | Baltimore, MD 21236-4902 |
Second Address | Baltimore, MD 21287-0011 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2008 |
Last Update Date | 07/01/2019 |