Healthcare Provider Details

I. General information

NPI: 1669459657
Provider Name (Legal Business Name): AARON RUBIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2005
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4881 SUGAR MAPLE DR
WRIGHT PATTERSON AFB OH
45433-5529
US

IV. Provider business mailing address

2510 5TH ST
WRIGHT PATTERSON AFB OH
45433-7951
US

V. Phone/Fax

Practice location:
  • Phone: 937-257-8718
  • Fax: 937-904-8946
Mailing address:
  • Phone: 937-938-2801
  • Fax: 937-904-8946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101238611
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License Number0101238611
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number0101238611
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0101238611
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: