Provider Demographics
NPI:1033152780
Name:HRUBY, JOHN S (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:S
Last Name:HRUBY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:709 W ORCHARD DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1766
Mailing Address - Country:US
Mailing Address - Phone:360-318-8800
Mailing Address - Fax:360-318-1085
Practice Address - Street 1:5580 NORDIC WAY
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:WA
Practice Address - Zip Code:98248
Practice Address - Country:US
Practice Address - Phone:360-384-1511
Practice Address - Fax:360-384-5758
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2012-07-24
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Provider Licenses
StateLicense IDTaxonomies
WAMD00017042207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1068352Medicaid
WA0128752OtherLABOR & INDUSTRIES (REG)
WA423898012OtherGROUP HEALTH COOPERATIVE
WA080141866OtherRAILROAD MEDICARE
WA8925033OtherLABOR & INDUSTRIES (CV)
WA01934OtherREGENCE BLUESHIELD
WA080141866OtherRAILROAD MEDICARE
WA423898012OtherGROUP HEALTH COOPERATIVE