Provider Demographics
NPI:1821015389
Name:RUBIN, EUGENE H (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:H
Last Name:RUBIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4511 FOREST PARK AVE
Mailing Address - Street 2:STE 4300
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-2138
Mailing Address - Country:US
Mailing Address - Phone:314-286-1700
Mailing Address - Fax:314-408-2756
Practice Address - Street 1:4940 CHILDRENS PL
Practice Address - Street 2:RM 3308
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1000
Practice Address - Country:US
Practice Address - Phone:314-286-1700
Practice Address - Fax:314-362-7017
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2021-11-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR94822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO201661501Medicaid
MO201661501Medicaid
MO020010213Medicare PIN