Provider Demographics
NPI:1861644833
Name:SUBRAMANIAN, ANURADHA (MD)
Entity Type:Individual
Prefix:MRS
First Name:ANURADHA
Middle Name:
Last Name:SUBRAMANIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 2ND ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-8100
Mailing Address - Country:US
Mailing Address - Phone:202-346-3131
Mailing Address - Fax:202-346-3132
Practice Address - Street 1:700 2ND ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-8100
Practice Address - Country:US
Practice Address - Phone:202-346-3131
Practice Address - Fax:202-346-3132
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD72836207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD335802000Medicaid
MD975343-01 & 02OtherCAREFIRST BC/BS
MDS062-0445OtherCAREFIRST BC/BS REGIONAL
MDP01108548Medicare PIN
MD225792Y27Medicare PIN