Provider Demographics
NPI:1811911092
Name:RUBIN, DAVID M (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:RUBIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:100 E PENN SQ
Mailing Address - Street 2:9TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-3323
Mailing Address - Country:US
Mailing Address - Phone:267-425-9232
Mailing Address - Fax:267-425-9299
Practice Address - Street 1:3550 MARKET ST FL 4
Practice Address - Street 2:CHOP CARE NEWORK AT MARKET ST
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-3368
Practice Address - Country:US
Practice Address - Phone:215-590-2178
Practice Address - Fax:215-590-4619
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2013-04-17
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Provider Licenses
StateLicense IDTaxonomies
PAMD065442L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001794986Medicaid
NJ8219109Medicaid
H13364Medicare UPIN
PA001794986Medicaid