Provider Demographics
NPI:1013151653
Name:SUBNANI, KISHORE (MD)
Entity Type:Individual
Prefix:
First Name:KISHORE
Middle Name:
Last Name:SUBNANI
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 1:3980 HIGHWAY 9 E STE 220
Mailing Address - Street 2:
Mailing Address - City:LITTLE RIVER
Mailing Address - State:SC
Mailing Address - Zip Code:29566-8164
Mailing Address - Country:US
Mailing Address - Phone:843-390-0877
Mailing Address - Fax:843-390-0881
Practice Address - Street 1:3980 HIGHWAY 9 E STE 220
Practice Address - Street 2:
Practice Address - City:LITTLE RIVER
Practice Address - State:SC
Practice Address - Zip Code:29566-8164
Practice Address - Country:US
Practice Address - Phone:843-390-0877
Practice Address - Fax:843-390-0881
Is Sole Proprietor?:No
Enumeration Date:2009-04-27
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC83488207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology