P.S. Subramaniam, MD, PC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

0101041206 Issued in VA

Legal business name

P.S. SUBRAMANIAM, MD, PC

Practice address

3400 Boulevard
Colonial Heights, VA 23834-1418

Phone

(804) 520-1157

NPI assigned

May 17, 2007

Last updated

Jul 30, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Poovillam S Subramaniam, M.D.

Title

President

Phone

(804) 520-1157

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Poovillam S Subramaniam, M.D., P.C. Other name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217376000000",
    "number": "1164639001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 WALSING DR",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232298133",
            "telephone_number": "804-520-1157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 BOULEVARD",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238341418",
            "telephone_number": "804-520-1157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P.S. SUBRAMANIAM, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2008-07-30",
        "status": "A",
        "authorized_official_last_name": "SUBRAMANIAM",
        "authorized_official_first_name": "POOVILLAM",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "804-520-1157",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VA",
            "license": "0101041206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "1013910652",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007100035",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Poovillam S Subramaniam, M.D., P.C.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Neurology Physician in Colonial Heights, VA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.