Provider Demographics
NPI:1831237841
Name:BRUBAKER, ROBERT MERLIN (HS)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:MERLIN
Last Name:BRUBAKER
Suffix:
Gender:M
Credentials:HS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 FOXCROFT DR
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-8735
Mailing Address - Country:US
Mailing Address - Phone:207-510-1258
Mailing Address - Fax:
Practice Address - Street 1:259 HIGH ST
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-2028
Practice Address - Country:US
Practice Address - Phone:207-741-5495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other