Provider Demographics
NPI:1376596353
Name:SUBHASH, SHREE (MD)
Entity Type:Individual
Prefix:
First Name:SHREE
Middle Name:
Last Name:SUBHASH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1635 N GEORGE MASON DR STE 130
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3680
Mailing Address - Country:US
Mailing Address - Phone:703-527-1500
Mailing Address - Fax:703-527-0190
Practice Address - Street 1:1635 N GEORGE MASON DR STE 130
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3680
Practice Address - Country:US
Practice Address - Phone:703-527-1500
Practice Address - Fax:703-527-0190
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101031031208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB94082Medicare UPIN