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Individual
SUBRAMANIAM R SHASTRI
Active
Individual
SUBRAMANIAM R SHASTRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
SS036858
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0A110280
BCBS
MI
01
—
290012718
RAIL ROAD MEDICARE
MI
Enumeration date
03/23/2006
Last updated
02/09/2015
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