Provider Demographics
NPI:1780883983
Name:SUBBA, BHARAT (MD)
Entity type:Individual
Prefix:
First Name:BHARAT
Middle Name:
Last Name:SUBBA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 MEMORIAL DR
Mailing Address - Street 2:MRH FIRSTHEALTH HOSPITALIST SERVICES.
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-8710
Mailing Address - Country:US
Mailing Address - Phone:910-715-1000
Mailing Address - Fax:910-715-4494
Practice Address - Street 1:155 MEMORIAL DR
Practice Address - Street 2:MRH FIRSTHEALTH HOSPITALIST SERVICES.
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8710
Practice Address - Country:US
Practice Address - Phone:910-715-1000
Practice Address - Fax:910-715-4494
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA239842208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2012-01657OtherNORTH CAROLINA MEDICAL BOARD LICENSE