Healthcare Provider Details

I. General information

NPI: 1710905476
Provider Name (Legal Business Name): DOUGLAS ROBERT RUBELMANN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 S GEORGE ST
YORK PA
17403-3676
US

IV. Provider business mailing address

3421 CONCORD RD
YORK PA
17402-9001
US

V. Phone/Fax

Practice location:
  • Phone: 717-851-2672
  • Fax: 717-851-2479
Mailing address:
  • Phone: 717-851-1405
  • Fax: 717-851-6969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD051367L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: