MEDICARE: DR. RUBEN DANIEL ACOSTA 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	207RG0100X	Gastroenterology Physician	D0095402	MD

General Provider Information

NPI Number	:	1376545962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RUBEN DANIEL ACOSTA M.D.

Provider Business Mailing Address
First Line	:	106 ASHTON KNOLLS LN
Second Line	:
City	:	ASHTON
State	:	MD
Zip	:	20861-3647
Country	:	US
Telephone Number	:	860-416-9313
Fax Number	:

Provider Business Practice Location Address
First Line	:	10801 LOCKWOOD DR STE 200
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20901-1562
Country	:	US
Telephone Number	:	301-593-2002
Fax Number	:

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

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	09/29/2023

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