Provider Demographics
NPI:1689623886
Name:DIGUMARTHY, SUBBA R (MD)
Entity Type:Individual
Prefix:
First Name:SUBBA
Middle Name:R
Last Name:DIGUMARTHY
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIANS ORGANIZATION INC
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-4254
Mailing Address - Fax:617-724-0046
Practice Address - Street 1:55 FRUIT STREET FND 2
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3117
Practice Address - Country:US
Practice Address - Phone:617-726-8354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2012-08-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA2185992085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology