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Individual

DR. STACEY LEIGH RUBIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4940 EASTERN AVE, GYN-OB RM 125, BALTIMORE, MD 21224-2735
(410) 550-0337
Mailing address
PO BOX 64313, BALTIMORE, MD 21264-4313

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
D79713
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100689400
MD
Enumeration date
08/04/2010
Last updated
10/14/2016
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