Healthcare Provider Details

I. General information

NPI: 1750397394
Provider Name (Legal Business Name): ERIK SAMUEL RUBINSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 BLUERIDGE AVE
SILVER SPRING MD
20902-4517
US

IV. Provider business mailing address

2401 BLUERIDGE AVE
SILVER SPRING MD
20902-4517
US

V. Phone/Fax

Practice location:
  • Phone: 301-933-6440
  • Fax: 301-933-5923
Mailing address:
  • Phone: 301-933-6440
  • Fax: 301-933-5923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0051970
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: