Provider Demographics
NPI:1154350999
Name:LUBKA, REUBEN NICHOLAS (MD)
Entity type:Individual
Prefix:DR
First Name:REUBEN
Middle Name:NICHOLAS
Last Name:LUBKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6401 UNIVERSITY AVE NE
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-4341
Mailing Address - Country:US
Mailing Address - Phone:763-572-5710
Mailing Address - Fax:763-571-3008
Practice Address - Street 1:6341 UNIVERSITY AVE NE
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-4946
Practice Address - Country:US
Practice Address - Phone:763-572-5710
Practice Address - Fax:763-586-5888
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN38018207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1008090OtherPREFERRED ONE
MNHP10917OtherHEALTHPARTNERS
MN904S7LUOtherBCBS OF MN
MN112836OtherUCARE MN#
MN0407201OtherMEDICA #
MN1754290OtherAMERICA'S PPO
MN0407201OtherMEDICA #