Provider Demographics
NPI:1508071531
Name:ELMAOUED, RUBA (MD)
Entity Type:Individual
Prefix:
First Name:RUBA
Middle Name:
Last Name:ELMAOUED
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 1:1713 WHITE CLOUD ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-4824
Mailing Address - Country:US
Mailing Address - Phone:315-744-8443
Mailing Address - Fax:
Practice Address - Street 1:750 EAST ADAMS ST
Practice Address - Street 2:UPSTATE UNIVERSITY HOSPITAL, DEAPRTMENT OF ANESTHESIA
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210
Practice Address - Country:US
Practice Address - Phone:315-744-8443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-12
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP3147207L00000X
NMNA208600000X
NMMD2011-0702207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208600000XAllopathic & Osteopathic PhysiciansSurgery