Healthcare Provider Details

I. General information

NPI: 1497879555
Provider Name (Legal Business Name): ROBERT RUBIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 05/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4777 E GALBRAITH RD
CINCINNATI OH
45236-2725
US

IV. Provider business mailing address

4777 E GALBRAITH RD
CINCINNATI OH
45236-2725
US

V. Phone/Fax

Practice location:
  • Phone: 513-686-5439
  • Fax: 513-686-3108
Mailing address:
  • Phone: 513-686-5439
  • Fax: 513-686-3108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.076552
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35076552R
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: