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Individual

JONATHAN RUBIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
471 E BROAD ST, SUITE 1400, COLUMBUS, OH 43215-3842
(614) 221-3303
Mailing address
1331 N ELM ST, SUITE 200, GREENSBORO, NC 27401-6302
(336) 274-9617
(336) 482-2177

Taxonomy

Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
35-07-8411
OH
2085R0202X
Diagnostic Radiology Physician
Primary
35-07-8411
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000226440
ANTHEM
OH
01
1603252
UNITED HEALTHCARE
OH
05
2309317
OH
01
2806775
AETNA
OH
05
64048952
KY
Enumeration date
07/12/2006
Last updated
06/24/2016
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