Provider Demographics
NPI:1073768164
Name:RUBACH, MATTHEW PALMER (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:PALMER
Last Name:RUBACH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF UTAH DEPT OF INTERNAL MEDICINE
Mailing Address - Street 2:SCHOOL OF MEDICINE 4C10, 30 N 1900 E
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84132-0001
Mailing Address - Country:US
Mailing Address - Phone:801-585-5559
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF UTAH DEPT OF INTERNAL MEDICINE
Practice Address - Street 2:SCHOOL OF MEDICINE 4C10, 30 N 1900 E
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-0001
Practice Address - Country:US
Practice Address - Phone:801-585-5559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program