Provider Demographics
NPI:1972557122
Name:RABIN, BRUCE ARLAN (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:ARLAN
Last Name:RABIN
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10753 FALLS RD STE 345
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-4598
Mailing Address - Country:US
Mailing Address - Phone:410-616-7188
Mailing Address - Fax:410-616-7131
Practice Address - Street 1:10753 FALLS RD STE 345
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-4598
Practice Address - Country:US
Practice Address - Phone:410-616-7188
Practice Address - Fax:410-616-7131
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2020-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00448502084N0600X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD644061401Medicaid
MD587M929FMedicare ID - Type Unspecified
MD644061401Medicaid