Provider Demographics
NPI:1578297388
Name:DULAL, SUBASH (MD)
Entity Type:Individual
Prefix:DR
First Name:SUBASH
Middle Name:
Last Name:DULAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1514 13TH AVE S APT 11
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-5453
Mailing Address - Country:US
Mailing Address - Phone:573-466-3316
Mailing Address - Fax:
Practice Address - Street 1:506 LENOX AVE RM 13106
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-1889
Practice Address - Country:US
Practice Address - Phone:212-939-1406
Practice Address - Fax:212-939-1462
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-16
Last Update Date:2022-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty