Provider Demographics
NPI:1457559585
Name:RUBINSON, DOUGLAS ADAM (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:ADAM
Last Name:RUBINSON
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 1:450 BROOKLINE AVE
Mailing Address - Street 2:DANA 1220K
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5418
Mailing Address - Country:US
Mailing Address - Phone:617-632-4405
Mailing Address - Fax:617-632-5370
Practice Address - Street 1:450 BROOKLINE AVE
Practice Address - Street 2:DANA 1220
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5418
Practice Address - Country:US
Practice Address - Phone:617-632-4405
Practice Address - Fax:617-632-5370
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA241786207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine