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NPI Code Detail

MEDICARE: FERN J RUBIN M.D.

MEDICARE: FERN J 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
1208000000XPediatrics Physician

General Provider Information

NPI Number : 1346579786
Entity Type Code : Organization
Provider Name (Legal Business Name) : FERN J RUBIN M.D.
Provider Business Mailing Address
First Line : 5851 DULUTH ST STE 317
Second Line :
City : GOLDEN VALLEY
State : MN
Zip : 55422-3957
Country : US
Telephone Number : 763-546-4301
Fax Number :
Provider Business Practice Location Address
First Line : 5851 DULUTH ST STE 317
Second Line :
City : GOLDEN VALLEY
State : MN
Zip : 55422-3957
Country : US
Telephone Number : 763-546-4301
Fax Number :
Authorized Official
Title or Position : M.D.
Name : DR. FERN JOY RUBIN
Credential : M.D.
Telephone Number : 763-546-4301
Provider Enumeration Date : 12/14/2009
Last Update Date : 12/14/2009

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