Dr. Poovillam S Subramaniam-Moothathu
Neurologist
3400 Boulevard
Colonial Heights
, Virginia 23834-1418
Dr. Poovillam S Subramaniam-Moothathu
Neurologist
3400 Boulevard
Colonial Heights
, Virginia 23834-1418
(804) 741-6484
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About
Features
Specialties
- Neurologist
Languages spoken
- English
Location
First Address
- Dr. Poovillam S Subramaniam-Moothathu
- 620 Walsing Dr
- Richmond, VA
- Zip : 23229-8133
- Phone : (804) 741-6484
Second Address
- Dr. Poovillam S Subramaniam-Moothathu
- 3400 Boulevard
- Colonial Heights, VA
- Zip : 23834-1418
- Phone : (804) 741-6484
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2084N0400X | Neurologist | 0101041206 | VA |
National Provider Identifier
| NPI | 1013910652 |
|---|---|
| Provider Name | Dr. Poovillam S Subramaniam-Moothathu |
| First Address | Richmond, VA 23229-8133 |
| Second Address | Colonial Heights, VA 23834-1418 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/05/2005 |
| Last Update Date | 10/08/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| C36491 | (02) | VA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.