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Individual
MARK TAGUE RUBERTUS
Active
Individual
MARK TAGUE RUBERTUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2009-00664
NC
207Q00000X
Family Medicine Physician
Primary
25954
OK
Other
Enumeration date
06/03/2006
Last updated
02/28/2011
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