Provider Demographics
NPI:1568555456
Name:RASHBAUM, BRUCE STEPHEN (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:STEPHEN
Last Name:RASHBAUM
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 1:3 TINGEY SQ SE PH 4
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-4935
Mailing Address - Country:US
Mailing Address - Phone:023-651-2342
Mailing Address - Fax:
Practice Address - Street 1:2300 M ST NW STE 910
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1434
Practice Address - Country:US
Practice Address - Phone:202-741-2222
Practice Address - Fax:202-677-6995
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC15084207R00000X
DCMD15084207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCB95127Medicare UPIN
DC015080C05Medicare ID - Type Unspecified