Provider Demographics
NPI:1528060456
Name:RUBIN, ALLAN M (MD)
Entity type:Individual
Prefix:
First Name:ALLAN
Middle Name:M
Last Name:RUBIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 HARROUN RD
Mailing Address - Street 2:SUITE 118
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-2182
Mailing Address - Country:US
Mailing Address - Phone:419-824-1399
Mailing Address - Fax:419-824-1455
Practice Address - Street 1:5300 HARROUN RD
Practice Address - Street 2:SUITE 118
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2182
Practice Address - Country:US
Practice Address - Phone:419-824-1399
Practice Address - Fax:419-824-1455
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35055273207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4198375OtherAETNA
OH503130025-00OtherBWC
OH000000317260OtherANTHEM
OH502130025-022OtherMMO
OH503130025-018OtherMMO
OHP00090521OtherRRMC
OH503130025-020OtherMMO
OH0658659OtherBCMH
OH910658OtherUHC
OH01140OtherPARAMOUNT
OH0658659Medicaid
OH503130025OtherHNFS
OH503130025-00OtherBWC
OHRU0597689Medicare ID - Type Unspecified
OHP00090521OtherRRMC
OH502130025-022OtherMMO
OHA16866Medicare UPIN