Provider Demographics
NPI:1669672408
Name:SUBHAS, GOKUL (MD)
Entity Type:Individual
Prefix:DR
First Name:GOKUL
Middle Name:
Last Name:SUBHAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2730 PIERCE ST STE 402
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51104-3766
Mailing Address - Country:US
Mailing Address - Phone:712-234-8725
Mailing Address - Fax:712-234-8728
Practice Address - Street 1:2730 PIERCE ST STE 402
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51104-3766
Practice Address - Country:US
Practice Address - Phone:712-234-8725
Practice Address - Fax:712-234-8728
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-42774208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery