Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 35-057355 | OH |
NPI | 1356750756 |
---|---|
Provider Name | Dr. Kanta Subbarao |
First Address | Bethesda, MD 20892-3203 |
Second Address | Bethesda, MD 20892-3203 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2014 |
Last Update Date | 11/08/2014 |