Individual
SUBRAMANYA S MALLIKARJUNAPPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1653 W CONGRESS PKWY, CHICAGO, IL 60612-3833
(888) 352-7874
Mailing address
1364 CLIFTON RD NE, ATLANTA, GA 30322-1059
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
125072796
IL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
91930
GA
Other
Enumeration date
07/25/2018
Last updated
06/14/2022
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