Individual
IDA JEAN RUBINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
44250 DEQUINDRE RD, STERLING HEIGHTS, MI 48314-1002
(248) 964-0400
(248) 964-0402
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301060062
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3403008
—
MI
Enumeration date
08/17/2006
Last updated
10/23/2020
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