Provider Demographics
NPI:1730113648
Name:SUBBARAO, ARAGAM R (MD)
Entity Type:Individual
Prefix:DR
First Name:ARAGAM
Middle Name:R
Last Name:SUBBARAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:717 STATE STREET, SUITE 16 LL
Mailing Address - Street 2:REGIONAL HEALTH SERVICES, INC.
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16501-1360
Mailing Address - Country:US
Mailing Address - Phone:814-877-7100
Mailing Address - Fax:814-877-2939
Practice Address - Street 1:4372 ROUTE 6
Practice Address - Street 2:KANE EMERGENCY DEPARTMENT
Practice Address - City:KANE
Practice Address - State:PA
Practice Address - Zip Code:16735
Practice Address - Country:US
Practice Address - Phone:814-837-8585
Practice Address - Fax:814-837-7905
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD024905E207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000908106Medicaid
PA107544Medicare PIN