Individual
BANUMATHY SUBRAMANIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
29703 HOOVER RD, STEB, WARREN, MI 48093-8901
(586) 573-9090
(586) 573-2128
Mailing address
20225 E 9 MILE RD, STE A, SAINT CLAIR SHORES, MI 48080-1700
(586) 573-9090
(586) 573-2128
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301076114
MI
Other
Enumeration date
08/03/2006
Last updated
03/10/2021
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