Provider Demographics
NPI:1407952674
Name:SUBRAMANIAM, SATISH
Entity type:Individual
Prefix:
First Name:SATISH
Middle Name:
Last Name:SUBRAMANIAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 DUKE MEDICINE CIR # DUMC 3148
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-4000
Mailing Address - Country:US
Mailing Address - Phone:919-684-3136
Mailing Address - Fax:
Practice Address - Street 1:4725 196TH ST SW
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-5518
Practice Address - Country:US
Practice Address - Phone:425-640-5115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000331912083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine