Provider Demographics
NPI:1457096539
Name:NANGARU SUBBAIAH, MILAN KUMAR (MBBS)
Entity Type:Individual
Prefix:DR
First Name:MILAN KUMAR
Middle Name:
Last Name:NANGARU SUBBAIAH
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:DR
Other - First Name:MILAN. S.
Other - Middle Name:
Other - Last Name:KUMAR. N.
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MBBS
Mailing Address - Street 1:THE WRIGHT CENTER OF GRADUATE MEDICAL EDUCATION
Mailing Address - Street 2:501 S. WASHINGTON AVE., SUITE 1000
Mailing Address - City:SCANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18505
Mailing Address - Country:US
Mailing Address - Phone:570-866-3058
Mailing Address - Fax:570-343-4800
Practice Address - Street 1:501 S. WASHINGTON AVE.
Practice Address - Street 2:
Practice Address - City:SCANTON
Practice Address - State:PA
Practice Address - Zip Code:18505
Practice Address - Country:US
Practice Address - Phone:570-290-3234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-03
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program