Provider Demographics
NPI:1598865891
Name:RUBENSTEIN, DONALD STEVEN (MD PHD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:STEVEN
Last Name:RUBENSTEIN
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 INDEPENDENCE PT
Mailing Address - Street 2:SUITE 212
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4545
Mailing Address - Country:US
Mailing Address - Phone:864-797-6044
Mailing Address - Fax:
Practice Address - Street 1:712 GROVE ROAD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4211
Practice Address - Country:US
Practice Address - Phone:864-271-1444
Practice Address - Fax:864-271-0948
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19218207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP2315Medicaid
SCGP1453Medicaid
SC192188Medicaid
SCGP2312Medicaid
SCGP2315Medicaid
SCAA53157951Medicare PIN
E54909Medicare UPIN
SCGP2312Medicaid
SC6091Medicare PIN