Provider Demographics
NPI:1780688267
Name:RUBENFELD, MARIAN R (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIAN
Middle Name:R
Last Name:RUBENFELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:825 NICOLLET MALL
Mailing Address - Street 2:STE 2000
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55402-2708
Mailing Address - Country:US
Mailing Address - Phone:612-338-4861
Mailing Address - Fax:612-333-8306
Practice Address - Street 1:825 NICOLLET MALL
Practice Address - Street 2:STE 2000
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55402-2708
Practice Address - Country:US
Practice Address - Phone:612-338-4861
Practice Address - Fax:612-333-8306
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN30299207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0822548OtherSELECTCARE
MN7D643RUOtherBLUE SHIELD
MN31527900OtherWISCONSIN MEDICAL ASSISTA
MN00646001OtherPREFERRED ONE
MN0800038OtherMEDICA PRIMARY
MN1021630002OtherADMINISTAR FEDERAL
MN200002101436OtherMETROPOLITAN HEALTH PLAN
MN0822548OtherMEDICA CHOICE
MNHP14286OtherHEALTHPARTNERS
MN0822548OtherMEDICA CHOICE