Provider Demographics
NPI:1962479782
Name:LUBIN, DAVID I (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:I
Last Name:LUBIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:712 CALHOUN RD
Mailing Address - Street 2:
Mailing Address - City:DAHLONEGA
Mailing Address - State:GA
Mailing Address - Zip Code:30533-5425
Mailing Address - Country:US
Mailing Address - Phone:706-344-7817
Mailing Address - Fax:706-867-1613
Practice Address - Street 1:743 SPRING ST NE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3715
Practice Address - Country:US
Practice Address - Phone:770-536-2146
Practice Address - Fax:770-536-7895
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA032425207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000408317IMedicaid
GA000408317JMedicaid
GA000408317NOtherMEDICAID URGENT CARE FRIENDSHIP
GA511I930014OtherMEDICARE PIN URGENT CARE FRIENDSHIP
GAB40572Medicare UPIN
GA000408317JMedicaid