Individual
DR. ILENE RUBOWITZ MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
14001 RIDGEDALE DR STE 100, HOPKINS, MN 55305-1781
(952) 473-0211
Mailing address
14001 RIDGEDALE DR, MINNETONKA, MN 55305-1753
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
45291
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
913119100
—
MN
Enumeration date
03/24/2006
Last updated
01/12/2024
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