Provider Demographics
NPI:1245613827
Name:RATH, SUBHENDU
Entity Type:Individual
Prefix:
First Name:SUBHENDU
Middle Name:
Last Name:RATH
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 1:1101 E MARSHALL ST, PO BOX 980599
Mailing Address - Street 2:VCU HEALTH DEPARTMENT OF NEUROLOGY
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298-5037
Mailing Address - Country:US
Mailing Address - Phone:706-296-7564
Mailing Address - Fax:
Practice Address - Street 1:1101 E MARSHALL ST DEPT OF
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5008
Practice Address - Country:US
Practice Address - Phone:804-628-2822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-01
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA01012720562084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program