MEDICARE: DR. RUTH A RABINOVITCH 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	207RI0200X	Infectious Disease Physician	207RI0200X	OR

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	:	1376521302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RUTH A RABINOVITCH M.D.

Provider Business Mailing Address
First Line	:	2941 DOCTORS PARK DR
Second Line	:
City	:	MEDFORD
State	:	OR
Zip	:	97504-8127
Country	:	US
Telephone Number	:	541-773-1590
Fax Number	:	541-773-7878

Provider Business Practice Location Address
First Line	:	2941 DOCTORS PARK DR
Second Line	:
City	:	MEDFORD
State	:	OR
Zip	:	97504-8127
Country	:	US
Telephone Number	:	541-773-1590
Fax Number	:	541-773-7878

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

Provider Enumeration Date	:	01/09/2006
Last Update Date	:	07/09/2007

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