Provider Demographics
NPI:1972509719
Name:RUBIN, STEVEN (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:RUBIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SEAGATE STE 800
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1558
Mailing Address - Country:US
Mailing Address - Phone:567-585-1992
Mailing Address - Fax:419-824-7359
Practice Address - Street 1:5300 HARROUN RD STE 10
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2182
Practice Address - Country:US
Practice Address - Phone:419-824-1952
Practice Address - Fax:419-824-0344
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010734362085R0001X
OH35-0731422085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N24000009OtherMEDICARE
OH2056199Medicaid
OH920005076OtherRR MEDICARE
MI4153886OtherMI MEDICAID-OH LOCATIONS
MI920006282OtherRR MEDICARE
MI4283002Medicaid
MI4283002Medicaid
MI920006282OtherRR MEDICARE
OHRU0842564Medicare ID - Type Unspecified