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General NPI Number Information
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NPI Number | 1801113386
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Entity Type | Individual
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Provider Name | GERARD RUBIN D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/23/2010
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Last Update Date | 05/04/2016
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Provider Practice Location Address
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Address Line | 6 E CHESTNUT ST STE 310
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City | AUGUSTA
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State | ME
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Zip | 04330-5717
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Country | US
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Telephone | 207-623-2977
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Fax | 207-621-1612
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Provider Business Mailing Address
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Address Line | 6 E CHESTNUT ST STE 310
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City | AUGUSTA
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State | ME
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Zip | 04330-5717
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Country | US
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Telephone | 207-623-2977
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Fax | 207-621-1612
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | DO2499
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License Number State | ME
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