Provider Demographics
NPI:1841232808
Name:RUBIN, MORTON LOUIS (MD)
Entity Type:Individual
Prefix:
First Name:MORTON
Middle Name:LOUIS
Last Name:RUBIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MRS
Other - First Name:SANDRA
Other - Middle Name:LOUISE
Other - Last Name:RUBIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2025 TECHNOLOGY PKWY
Mailing Address - Street 2:SUITE 109
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-9400
Mailing Address - Country:US
Mailing Address - Phone:717-791-2600
Mailing Address - Fax:717-791-2601
Practice Address - Street 1:2025 TECHNOLOGY PKWY
Practice Address - Street 2:SUITE 109
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-9400
Practice Address - Country:US
Practice Address - Phone:717-791-2600
Practice Address - Fax:717-791-2601
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD010217E207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA162627OtherHIGHMARK BLUE SHIELD
PA02993501OtherCAPITAL BLUE CROSS
PA0466708OtherAETNA
PA0649318Medicaid
162627Medicare ID - Type Unspecified
PA02993501OtherCAPITAL BLUE CROSS