Provider Demographics
NPI:1871532663
Name:RUBEN, GARRY DENNIS (MD)
Entity type:Individual
Prefix:DR
First Name:GARRY
Middle Name:DENNIS
Last Name:RUBEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11120 NEW HAMPSHIRE AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-2633
Mailing Address - Country:US
Mailing Address - Phone:301-681-3900
Mailing Address - Fax:301-681-8305
Practice Address - Street 1:11120 NEW HAMPSHIRE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-2633
Practice Address - Country:US
Practice Address - Phone:301-681-3900
Practice Address - Fax:301-681-8305
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2023-12-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD211532086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD398111800Medicaid
MD184853Medicare ID - Type Unspecified