Provider Demographics
NPI:1093774366
Name:LAHIRY, SUBRAT K (MD)
Entity Type:Individual
Prefix:
First Name:SUBRAT
Middle Name:K
Last Name:LAHIRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1600 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 2500
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3656
Mailing Address - Country:US
Mailing Address - Phone:304-691-1200
Mailing Address - Fax:304-691-1287
Practice Address - Street 1:1600 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 2500
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3656
Practice Address - Country:US
Practice Address - Phone:304-691-1200
Practice Address - Fax:304-691-1287
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2021-11-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WV11583208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0128073000Medicaid
OH0370530Medicaid
KY64695943Medicaid
WV0447167Medicare ID - Type Unspecified
OH0370530Medicaid