Individual
BRUCE KALMAN RUBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MENGR, MBA
Contact information
Practice address
1000 E BROAD ST, RICHMOND, VA 23219-1930
(804) 828-2467
(804) 828-9439
Mailing address
PO BOX 780125, PHILADELPHIA, PA 19178-0125
(804) 922-4844
Taxonomy
Speciality
Code
Description
License number
State
2080P0214X
Pediatric Pulmonology Physician
Primary
0101246124
VA
2080P0214X
Pediatric Pulmonology Physician
9701576
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093T
BCBS
—
01
—
17762
PARTNERS
—
05
—
220407000
—
WV
01
—
370020986
RR MEDICARE
—
05
—
6729738
—
VA
01
—
7556338
AETNA
—
01
—
76111
MEDCOST
—
05
—
891093T
—
NC
05
—
Q0157C
—
SC
Enumeration date
12/02/2005
Last updated
06/11/2024
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