MEDICARE: DR. DAVID PAUL RUBY DO

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	207P00000X	Emergency Medicine Physician	1773	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	K35501L	OTHER	AZ	AZ MEDICARE PROVIDER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912921917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID PAUL RUBY DO

Provider Business Mailing Address
First Line	:	1119 E LE MARCHE AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85022-3136
Country	:	US
Telephone Number	:	602-795-0861
Fax Number	:

Provider Business Practice Location Address
First Line	:	1119 E LE MARCHE AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85022-3136
Country	:	US
Telephone Number	:	602-795-0861
Fax Number	:

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	10/20/2007

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