Provider Demographics
NPI:1972518488
Name:SUBRAMANYA, AROHAN RAM (MD)
Entity type:Individual
Prefix:
First Name:AROHAN
Middle Name:RAM
Last Name:SUBRAMANYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2620 GUILFORD AVE APT 2
Mailing Address - Street 2:APARTMENT #2
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-4611
Mailing Address - Country:US
Mailing Address - Phone:410-746-7008
Mailing Address - Fax:
Practice Address - Street 1:660 W REDWOOD ST
Practice Address - Street 2:HOWARD HALL 517
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1541
Practice Address - Country:US
Practice Address - Phone:410-706-2653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD23191207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR022982Medicaid
OR022982Medicaid