Individual
RUBIN PETER GAPPY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
20225 E 9 MILE RD, SUITE A, SAINT CLAIR SHORES, MI 48080-1775
(586) 772-1090
(586) 772-4366
Mailing address
46591 ROMEO PLANK RD, SUITE 205, MACOMB, MI 48044-5742
(586) 226-6252
(586) 226-6255
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301081978
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301081978
PHYS LICENSE
MI
01
—
5315028539
CONT SUB LICENSE
MI
Enumeration date
08/08/2006
Last updated
07/08/2007
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