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General NPI Number Information
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NPI Number | 1619936531
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Entity Type | Organization
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Legal Business Name | SURGICAL SPECIALISTS OF THE NORTH SHORE,INC
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Dates
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Enumeration Date | 03/20/2006
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Last Update Date | 11/05/2007
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Provider Practice Location Address
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Address Line | 331 HIGHLAND AVE
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City | SALEM
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State | MA
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Zip | 01970-1738
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Country | US
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Telephone | 978-745-2639
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Fax |
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Provider Business Mailing Address
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Address Line | 331 HIGHLAND AVE
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City | SALEM
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State | MA
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Zip | 01970-1738
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Country | US
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Telephone | 978-745-2639
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARC STUART RUBIN
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Credential | MD
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Telephone | 978-745-2639
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2086S0120X
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Taxonomy Name | Pediatric Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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