Provider Demographics
NPI:1992790158
Name:RUBEN, ALAN M (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:M
Last Name:RUBEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 894830
Mailing Address - Street 2:LOCK BOX 4830
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90189-4830
Mailing Address - Country:US
Mailing Address - Phone:304-232-7151
Mailing Address - Fax:304-232-6128
Practice Address - Street 1:2101 CHAPLINE ST
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-3875
Practice Address - Country:US
Practice Address - Phone:304-232-7151
Practice Address - Fax:304-232-6128
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV11124207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA126124XF4OtherPTAN FOR JOEL SIEGEL PRACTICE
PAP00654345OtherMEDICARE RAILROAD
PAP00767380OtherRAILROAD MEDICARE
PARU2030643OtherHIGHMARK BLUE SHIELD
WV0432057Medicare PIN
PA126124YPTMedicare PIN
PARU2030643OtherHIGHMARK BLUE SHIELD
PAP00767380OtherRAILROAD MEDICARE
PA126124ZEGSMedicare PIN