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General NPI Number Information
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NPI Number | 1912633967
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Entity Type | Individual
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Provider Name | DANIEL ROBERT RUBIO III MD
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Gender | Male
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Dates
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Enumeration Date | 07/30/2022
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 2031 PEACH ST
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City | WISCONSIN RAPIDS
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State | WI
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Zip | 54494-5181
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Country | US
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Telephone | 715-423-0122
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Fax |
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Provider Business Mailing Address
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Address Line | 425 WIND RIDGE DR
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City | WAUSAU
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State | WI
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Zip | 54401-4149
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Country | US
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Telephone | 715-675-3391
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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 | 83469-20
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License Number State | WI
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