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Individual

MUTHIAH SUBRAMANIAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
4220 HOSPITAL DR, EAST CHINA, MI 48054-2200
(810) 329-4736
Mailing address
2656 BYRD ST, DEARBORN, MI 48124-4180
(313) 271-4654
(313) 271-3442

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301061409
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1108200562
BLUE CROSS BLUE SHIELD
MI
Enumeration date
10/25/2006
Last updated
07/08/2007
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