Individual
DR. SUBRAMANYAM YADAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4201 CAMPUS RIDGE DRIVE, MIDLAND, MI 48640
(989) 488-5450
(989) 488-5455
Mailing address
4201 CAMPUS RIDGEDRIVE, MIDLAND, MI 48640
(989) 488-5450
(989) 488-5455
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
SY038909
MI
207RP1001X
Pulmonary Disease Physician
Primary
SY038909
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2120984
—
MI
01
—
2905610541
BLUE CROSS BLUE SHIELD
MI
Enumeration date
08/26/2006
Last updated
11/02/2016
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