Provider Demographics
NPI:1659469732
Name:VENKATASUBRAMANI, NARAYANAN (MD, MRCP, MBBS)
Entity Type:Individual
Prefix:DR
First Name:NARAYANAN
Middle Name:
Last Name:VENKATASUBRAMANI
Suffix:
Gender:M
Credentials:MD, MRCP, MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5213 S ALSTON AVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-4430
Mailing Address - Country:US
Mailing Address - Phone:919-684-8111
Mailing Address - Fax:
Practice Address - Street 1:2100 ERWIN RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3941
Practice Address - Country:US
Practice Address - Phone:919-684-8111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI482792080P0206X
NC2012-010062080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1659469732Medicaid
WI2546941OtherUHC
WI1659469732Medicaid
WI113673601Medicare PIN
WI602550062Medicare PIN
WI680860551Medicare PIN