Provider Demographics
NPI:1295773794
Name:LUBAN, NORMAN A I (MD)
Entity type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:A
Last Name:LUBAN
Suffix:I
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10400 CONNECTICUT AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-3910
Mailing Address - Country:US
Mailing Address - Phone:301-949-0607
Mailing Address - Fax:301-949-6603
Practice Address - Street 1:10400 CONNECTICUT AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-3910
Practice Address - Country:US
Practice Address - Phone:301-949-0607
Practice Address - Fax:301-949-6603
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD144182084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0465610Medicaid
DC1823 0001OtherBLUE CROSS OF DC
DC130015147OtherRAILROAD MEDICARE
DC2056509OtherAETNA
DC498185OtherNCPPO
DC310871600Medicaid
MD54318302OtherBC BS MARYLAND
DC310871600Medicaid
DCB93083Medicare UPIN