Healthcare Provider Details

I. General information

NPI: 1356377642
Provider Name (Legal Business Name): LEON RUBINSZTAIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 CLAIRMONT RD DEPARTMENT OF RADIOLOGY
DECATUR GA
30033-4004
US

IV. Provider business mailing address

50 BISCAYNE DR NW UNIT # 5113
ATLANTA GA
30309-1039
US

V. Phone/Fax

Practice location:
  • Phone: 404-321-6111
  • Fax:
Mailing address:
  • Phone: 678-534-8378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberMD418451
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: