MEDICARE: CARL RUEBEN JAY JR. D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	213E00000X	Podiatrist	5901002483	MI

General Provider Information

NPI Number	:	1376981290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARL RUEBEN JAY JR. D.P.M.

Provider Business Mailing Address
First Line	:	43494 WOODWARD AVE STE 208
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-5054
Country	:	US
Telephone Number	:	810-206-1402
Fax Number	:

Provider Business Practice Location Address
First Line	:	43494 WOODWARD AVE STE 208
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-5054
Country	:	US
Telephone Number	:	810-206-1402
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2013
Last Update Date	:	04/06/2026

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