Provider Demographics
NPI:1538180575
Name:RUBIO, MARRIETH GARCIELA (MD)
Entity type:Individual
Prefix:DR
First Name:MARRIETH
Middle Name:GARCIELA
Last Name:RUBIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 RIVERSIDE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016
Mailing Address - Country:US
Mailing Address - Phone:540-224-5170
Mailing Address - Fax:540-983-8229
Practice Address - Street 1:3 RIVERSIDE CIRCLE
Practice Address - Street 2:VA GULF COAST HEALTHCARE SYSTEM (111)
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016
Practice Address - Country:US
Practice Address - Phone:540-224-5170
Practice Address - Fax:540-983-8229
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12454R207RG0100X, 207RI0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC9800132OtherMEDICAL LICENSE
LA12454ROtherMEDICAL LICENSE
LAV181009OtherTAXONOMY NUMBER