MEDICARE: MARTIN RUBIN M.D.

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	207Y00000X	Otolaryngology Physician	D0027309	MD

General Provider Information

NPI Number	:	1922167147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTIN RUBIN M.D.

Provider Business Mailing Address
First Line	:	8186 LARK BROWN RD
Second Line	:	SUITE 303
City	:	ELKRIDGE
State	:	MD
Zip	:	21075-6433
Country	:	US
Telephone Number	:	410-799-5111
Fax Number	:	410-799-5003

Provider Business Practice Location Address
First Line	:	8186 LARK BROWN RD
Second Line	:	SUITE 303
City	:	ELKRIDGE
State	:	MD
Zip	:	21075-6433
Country	:	US
Telephone Number	:	410-799-5111
Fax Number	:	410-799-5003

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

Provider Enumeration Date	:	12/06/2006
Last Update Date	:	07/08/2007

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