Provider Demographics
NPI:1164945077
Name:SUBEDI, SUBASH CHANDRA
Entity Type:Individual
Prefix:
First Name:SUBASH
Middle Name:CHANDRA
Last Name:SUBEDI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MERCY LN STE 405
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6441
Mailing Address - Country:US
Mailing Address - Phone:501-609-2222
Mailing Address - Fax:501-321-9689
Practice Address - Street 1:1 MERCY LN STE 405
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6441
Practice Address - Country:US
Practice Address - Phone:501-609-2222
Practice Address - Fax:501-321-9689
Is Sole Proprietor?:No
Enumeration Date:2017-07-23
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-13436208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist