Provider Demographics
NPI:1235108184
Name:TUCSON INPATIENT MEDICINE PLLC
Entity Type:Organization
Organization Name:TUCSON INPATIENT MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SUBBUREDDIAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-297-8733
Mailing Address - Street 1:6556 E CARONDELET DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-2117
Mailing Address - Country:US
Mailing Address - Phone:520-296-8733
Mailing Address - Fax:
Practice Address - Street 1:6556 E CARONDELET DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-2117
Practice Address - Country:US
Practice Address - Phone:520-296-8733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TUCSON INPATIENT MEDICINE PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-14
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ30466207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty