MEDICARE: PETER BRYAN RUBENSTEIN 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	207L00000X	Anesthesiology Physician	MD60770459	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275809329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER BRYAN RUBENSTEIN M.D.

Provider Business Mailing Address
First Line	:	909 SQUALICUM WAY STE 102
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-2077
Country	:	US
Telephone Number	:	360-647-3377
Fax Number	:	360-752-3214

Provider Business Practice Location Address
First Line	:	909 SQUALICUM WAY STE 102
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-2077
Country	:	US
Telephone Number	:	360-647-3377
Fax Number	:	360-752-3214

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

Provider Enumeration Date	:	03/22/2012
Last Update Date	:	05/27/2020

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