Provider Demographics
NPI:1811959539
Name:DAS, SUBRAMONIUM K (MD)
Entity type:Individual
Prefix:
First Name:SUBRAMONIUM
Middle Name:K
Last Name:DAS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1013 MEDICAL CENTER PKWY
Mailing Address - Street 2:BUILDING 2
Mailing Address - City:SELMA
Mailing Address - State:AL
Mailing Address - Zip Code:36701-6742
Mailing Address - Country:US
Mailing Address - Phone:334-875-2266
Mailing Address - Fax:334-875-2277
Practice Address - Street 1:1013 MEDICAL CENTER PKWY
Practice Address - Street 2:BUILDING 2
Practice Address - City:SELMA
Practice Address - State:AL
Practice Address - Zip Code:36701-6742
Practice Address - Country:US
Practice Address - Phone:334-875-2266
Practice Address - Fax:334-875-2277
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-06
Last Update Date:2007-07-09
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Provider Licenses
StateLicense IDTaxonomies
AL9535207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510-07196OtherBLUE CROSS PROVIDER
AL0410132OtherUNTIDED HEALTHCARE
ALC73240Medicare UPIN