Provider Demographics
NPI:1295848885
Name:RUBY, ERIC JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:JAMES
Last Name:RUBY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:35 SUMMER STREET
Mailing Address - Street 2:SUITE 103
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-3469
Mailing Address - Country:US
Mailing Address - Phone:508-823-2296
Mailing Address - Fax:508-823-7044
Practice Address - Street 1:35 SUMMER STREET
Practice Address - Street 2:SUITE 103
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3469
Practice Address - Country:US
Practice Address - Phone:508-823-2296
Practice Address - Fax:508-823-7044
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA41351208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2054736Medicaid
MAE03240Medicare UPIN