Provider Demographics
NPI:1396747093
Name:RUBINOW, SIDNEY DAVID (DO)
Entity type:Individual
Prefix:DR
First Name:SIDNEY
Middle Name:DAVID
Last Name:RUBINOW
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 NEBULA CT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-0905
Mailing Address - Country:US
Mailing Address - Phone:719-475-8994
Mailing Address - Fax:719-575-9930
Practice Address - Street 1:740 NEBULA CT
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-0905
Practice Address - Country:US
Practice Address - Phone:719-475-8994
Practice Address - Fax:719-575-9930
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO25275207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01252758Medicaid
CO01252758Medicaid
COD24061Medicare UPIN