MEDICARE: ROY M RUBIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	18249	GA

General Provider Information

NPI Number	:	1093129678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROY M RUBIN M.D.

Provider Business Mailing Address
First Line	:	3806 ASHFORD KNLS NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30319-1868
Country	:	US
Telephone Number	:	770-452-9696
Fax Number	:

Provider Business Practice Location Address
First Line	:	3806 ASHFORD KNLS NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30319-1868
Country	:	US
Telephone Number	:	770-452-9696
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2014
Last Update Date	:	06/11/2014

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