Individual
SUBBARAJU BUDHARAJU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.B.B.S.
Contact information
Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 395-6665
(937) 395-6668
Mailing address
1 PRESTIGE PL STE 550, MIAMISBURG, OH 45342-6115
(937) 762-1305
(937) 522-7513
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
35.122849
OH
208M00000X
Hospitalist Physician
Primary
35.122849
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0107858
—
OH
Enumeration date
04/27/2011
Last updated
05/05/2023
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