MEDICARE: BLAIR I REUBEN MD

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	174400000X	Specialist	27349	AZ

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	:	1619919453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BLAIR I REUBEN MD

Provider Business Mailing Address
First Line	:	9250 N THIRD STREET
Second Line	:	SUITE 4000
City	:	PHOENIX
State	:	AZ
Zip	:	85020-2412
Country	:	US
Telephone Number	:	602-633-3800
Fax Number	:	602-861-3500

Provider Business Practice Location Address
First Line	:	9250 N. THIRD STREET
Second Line	:	SUITE 4000
City	:	PHOENIX
State	:	AZ
Zip	:	85020-2412
Country	:	US
Telephone Number	:	602-633-3800
Fax Number	:	602-861-3500

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	12/09/2010

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Directions to “ BLAIR I REUBEN MD” Practice Location

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