Provider Demographics
NPI:1437225836
Name:RUBIN, CARRIE M (MD)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:M
Last Name:RUBIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3043 SANITARIUM RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-4600
Mailing Address - Country:US
Mailing Address - Phone:330-628-2818
Mailing Address - Fax:330-253-8619
Practice Address - Street 1:3043 SANITARIUM RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-4600
Practice Address - Country:US
Practice Address - Phone:330-628-2818
Practice Address - Fax:330-253-8619
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.072797208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2054744Medicaid
OH2054744Medicaid