Individual
BRYON EVAN RUBERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
186 KIMEL PARK DR, WINSTON SALEM, NC 27103-6946
(336) 277-2000
(336) 277-2050
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(336) 277-2000
(336) 277-2050
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
200100276
NC
207RC0000X
Cardiovascular Disease Physician
200100276
NC
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
200100276
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1286C
BCBS
NC
05
—
1447297833
—
VA
01
—
190065
MEDCOST
NC
05
—
3810007248
—
WV
01
—
41917
PARTNERS
NC
05
—
5905499
—
NC
01
—
7659265
AETNA
NC
05
—
Q0027N
—
SC
Enumeration date
06/02/2006
Last updated
10/25/2020
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