Basic Information
| Provider Information | |||||||||
| NPI: | 1205161114 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BRUCE RUBEN,M.D.,P.C. | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 2300 HAGGERTY RD | ||||||||
| Address2: | SUITE 1190 | ||||||||
| City: | WEST BLOOMFIELD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483232184 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2486249800 | ||||||||
| FaxNumber: | 2486249825 | ||||||||
| Practice Location | |||||||||
| Address1: | 2300 HAGGERTY RD | ||||||||
| Address2: | SUITE 1190 | ||||||||
| City: | WEST BLOOMFIELD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483232184 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2486249800 | ||||||||
| FaxNumber: | 2486249825 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/09/2009 | ||||||||
| LastUpdateDate: | 05/20/2014 | ||||||||
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| AuthorizedOfficialLastName: | RUBEN | ||||||||
| AuthorizedOfficialFirstName: | BRUCE | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2486249800 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.