Provider Demographics
NPI:1295848570
Name:RUBRIGHT, ERIK M (DO)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:M
Last Name:RUBRIGHT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:145 5TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:GLADSTONE
Mailing Address - State:MI
Mailing Address - Zip Code:49837-1929
Mailing Address - Country:US
Mailing Address - Phone:906-428-3273
Mailing Address - Fax:906-428-1881
Practice Address - Street 1:145 5TH AVE NE
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:MI
Practice Address - Zip Code:49837-1929
Practice Address - Country:US
Practice Address - Phone:906-428-3273
Practice Address - Fax:906-428-1881
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101013406207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1295848570Medicaid
MI080114637OtherRR MEDICARE GROUP#CC2139
MI3422667Medicaid
MI080114637OtherRR MEDICARE GROUP#CC2139