Healthcare Provider Details

I. General information

NPI: 1033451471
Provider Name (Legal Business Name): JESSICA HODGE RUBENS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2013
Last Update Date: 07/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

THE JOHNS HOPKINS HOSPITAL 1800 ORLEANS STREET
BALTIMORE MD
21287-0001
US

IV. Provider business mailing address

120 CROYDON RD
BALTIMORE MD
21212-3301
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-2727
  • Fax:
Mailing address:
  • Phone: 619-889-6212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0080890
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: