Provider Demographics
NPI:1639226236
Name:RUBINO, DOMENICA MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:DOMENICA
Middle Name:MARIE
Last Name:RUBINO
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 1:2800 S SHIRLINGTON RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-3601
Mailing Address - Country:US
Mailing Address - Phone:703-807-0037
Mailing Address - Fax:703-807-0038
Practice Address - Street 1:2800 S SHIRLINGTON RD
Practice Address - Street 2:SUITE 500
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206-3601
Practice Address - Country:US
Practice Address - Phone:703-807-0037
Practice Address - Fax:703-807-0038
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD32032207RE0101X
VA0101222197207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAH10557Medicare UPIN