Provider Demographics
NPI:1215903653
Name:DUGGIRALA, SUBASH BABU (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:SUBASH
Middle Name:BABU
Last Name:DUGGIRALA
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1406 WOODWELL RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-2080
Mailing Address - Country:US
Mailing Address - Phone:240-476-1884
Mailing Address - Fax:
Practice Address - Street 1:1406 WOODWELL RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-2080
Practice Address - Country:US
Practice Address - Phone:240-476-1884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD367262083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD529869Medicare ID - Type Unspecified