Healthcare Provider Details

I. General information

NPI: 1861484883
Provider Name (Legal Business Name): RUFUS A REUBEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 05/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 GRAHAM RD SUITE 4
CUYAHOGA FALLS OH
44223-2259
US

IV. Provider business mailing address

275 GRAHAM RD STE 4
CUYAHOGA FALLS OH
44223-2259
US

V. Phone/Fax

Practice location:
  • Phone: 330-926-9409
  • Fax: 330-926-9428
Mailing address:
  • Phone: 330-926-9409
  • Fax: 330-926-9428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35-06-6099R
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number35-06-6099R
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: