Provider Demographics
NPI:1023435203
Name:ROBERT I. LUBIN, D.P.M., P. L.L.C
Entity type:Organization
Organization Name:ROBERT I. LUBIN, D.P.M., P. L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPM/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-819-0249
Mailing Address - Street 1:PO BOX 3299
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48333-3299
Mailing Address - Country:US
Mailing Address - Phone:248-819-0249
Mailing Address - Fax:248-489-0545
Practice Address - Street 1:6512 N CANTON CENTER RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-1652
Practice Address - Country:US
Practice Address - Phone:248-819-0249
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-25
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901000759310400000X
213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No310400000XNursing & Custodial Care FacilitiesAssisted Living FacilityGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1760686000Medicare UPIN