Provider Demographics
NPI:1891918546
Name:RUBIO, SANDRA L (DC)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:L
Last Name:RUBIO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 SHERANDO TRAIL
Mailing Address - Street 2:
Mailing Address - City:HEDGESVILLE,
Mailing Address - State:WV
Mailing Address - Zip Code:25427
Mailing Address - Country:US
Mailing Address - Phone:301-980-9627
Mailing Address - Fax:
Practice Address - Street 1:2730 UNIVERSITY BLVD W #500
Practice Address - Street 2:#500
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902
Practice Address - Country:US
Practice Address - Phone:301-980-9627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01683111N00000X, 111NN1001X, 111NR0400X, 111NS0005X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NS0005XChiropractic ProvidersChiropractorSports Physician
No111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDCB52-0000OtherCAREFIRST PROVIDER NUMBER
MDU42096Medicare UPIN
MD4624-0003OtherCAREFIRST
MD534-76001OtherBLUECROSS BLUESHIELD
MD6456844001OtherCIGNA