Healthcare Provider Details

I. General information

NPI: 1417940057
Provider Name (Legal Business Name): DON RUBINO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DON MARINO RUBINO M.D.

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 01/15/2020
Certification Date: 01/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1453 HICKORY HOLLOW DR
FLINT MI
48532-2057
US

IV. Provider business mailing address

1453 HICKORY HOLLOW DR
FLINT MI
48532-2057
US

V. Phone/Fax

Practice location:
  • Phone: 810-733-8187
  • Fax:
Mailing address:
  • Phone: 810-733-8187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301029987
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: