Organization
P.S. SUBRAMANIAM, MD, PC
Active
Other names
Poovillam S Subramaniam, M.D., P.C.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. POOVILLAM S SUBRAMANIAM M.D. (PRESIDENT)
(804) 520-1157
Entity
Organization
Contact information
Practice address
3400 BOULEVARD, COLONIAL HEIGHTS, VA 23834-1418
(804) 520-1157
Mailing address
620 WALSING DR, RICHMOND, VA 23229-8133
(804) 520-1157
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
0101041206
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007100035
—
VA
01
—
1013910652
ANTHEM
VA
Enumeration date
05/17/2007
Last updated
07/30/2008
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