Provider Demographics
NPI:1376545962
Name:ACOSTA, RUBEN DANIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:RUBEN
Middle Name:DANIEL
Last Name:ACOSTA
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 1:106 ASHTON KNOLLS LN
Mailing Address - Street 2:
Mailing Address - City:ASHTON
Mailing Address - State:MD
Mailing Address - Zip Code:20861-3647
Mailing Address - Country:US
Mailing Address - Phone:860-416-9313
Mailing Address - Fax:
Practice Address - Street 1:10801 LOCKWOOD DR STE 200
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-1562
Practice Address - Country:US
Practice Address - Phone:301-593-2002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0095402207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology