Provider Demographics
NPI:1861431322
Name:RUBIN, MARTIN H (MD)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:H
Last Name:RUBIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2733 N POWER RD
Mailing Address - Street 2:SUITE #102 PMB #452
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85215-1682
Mailing Address - Country:US
Mailing Address - Phone:480-839-7627
Mailing Address - Fax:480-839-7643
Practice Address - Street 1:2733 N POWER RD
Practice Address - Street 2:SUITE #102 PMB #452
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85215-1682
Practice Address - Country:US
Practice Address - Phone:480-839-7627
Practice Address - Fax:480-839-7643
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2014-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12996207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ4058198OtherAETNA
AZAZ0037030OtherBCBS
AZ0400085OtherUNITED HEALTHCARE
AZ1095001OtherCIGNA
AZ226432Medicaid
AZ226432Medicaid