Provider Demographics
NPI:1922291137
Name:RUBLE, DEAN ALAN (DO)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:ALAN
Last Name:RUBLE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6701 BOCA VISTA DR NE UNIT 102
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-9655
Mailing Address - Country:US
Mailing Address - Phone:616-255-5338
Mailing Address - Fax:
Practice Address - Street 1:8200 OLD 13 MILE RD STE 101
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-2171
Practice Address - Country:US
Practice Address - Phone:616-255-5338
Practice Address - Fax:586-510-4141
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101013173207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine