Individual provider Active NPI

Subin Punnen, MD

  • Surgery Physician
  • Southfield, MI
National Provider Identifier
1376471979
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4352001248 Issued in MI
Practice address
22250 Providence Dr Ste 206
Southfield, MI 48075-6210
Phone
(248) 662-4333
NPI assigned
May 12, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 4352001248 MI Primary

Addresses

Primary practice location

22250 Providence Dr Ste 206
Southfield, MI 48075-6210

Mailing address

22250 Providence Dr Ste 206
Southfield, MI 48075-6210
Phone (248) 662-4333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260608001174 MI Order and Referring Only - General SurgeryPractitioner - General Surgery 8325519663

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4352001248MIMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1778544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1376471979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR STE 206",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480756210",
            "telephone_number": "248-662-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR STE 206",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480756210",
            "telephone_number": "248-662-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUNNEN",
        "first_name": "SUBIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-05-12",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "MI",
            "license": "4352001248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.