Provider Demographics
NPI:1952842189
Name:RUBIN, SAMUEL (MD, MPH)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:
Last Name:RUBIN
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:490 E NORTH AVE STE 515
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4780
Mailing Address - Country:US
Mailing Address - Phone:412-681-2300
Mailing Address - Fax:
Practice Address - Street 1:490 E NORTH AVE STE 515
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4780
Practice Address - Country:US
Practice Address - Phone:412-681-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-20
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD482281207Y00000X
MA271418207Y00000X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
16022608OtherCAQH