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General NPI Number Information
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NPI Number | 1497498729
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Entity Type | Individual
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Provider Name | RUBA MATEEN DO
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Gender | Female
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Dates
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Enumeration Date | 04/14/2022
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 205 N EAST AVE
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City | JACKSON
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State | MI
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Zip | 49201-1753
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Country | US
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Telephone | 517-205-4800
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Fax |
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Provider Business Mailing Address
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Address Line | 134 BOWER LN
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City | FOREST HILL
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State | MD
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Zip | 21050-1749
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Country | US
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Telephone | 443-617-0790
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5101028916
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License Number State | MI
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