Provider Demographics
NPI:1114944758
Name:RUBIN, FRED H (MD)
Entity Type:Individual
Prefix:
First Name:FRED
Middle Name:H
Last Name:RUBIN
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:5230 CENTRE AVENUE
Mailing Address - Street 2:#341 SCHOOL OF NURSING BUILDING UPMC SHADYSIDE HOSPITAL
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232
Mailing Address - Country:US
Mailing Address - Phone:412-623-2518
Mailing Address - Fax:412-623-2555
Practice Address - Street 1:5200 CENTRE AVENUE
Practice Address - Street 2:STE 405
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232
Practice Address - Country:US
Practice Address - Phone:412-623-2700
Practice Address - Fax:412-623-1235
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD019241E207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA473855OtherHIGHMARK BCBS
PA0011057220Medicaid
B72539Medicare UPIN
PA0011057220Medicaid