Individual
DR. GORANTLA SUBBA RAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1425 WEATHERLY RD SE, HUNTSVILLE, AL 35803-1178
(256) 881-1111
(256) 882-1410
Mailing address
1425 WEATHERLY RD SE, HUNTSVILLE, AL 35803-1178
(256) 881-1111
(256) 882-1410
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
8243
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000060906
—
AL
01
—
4036876
AETNA
AL
Enumeration date
05/23/2006
Last updated
10/30/2023
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