Individual
RAHUL SRIDHAR SUBBARAYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
444 N WESTHILL BLVD, APPLETON, WI 54914-5715
(920) 969-1768
(920) 267-5222
Mailing address
119 E BELL ST, NEENAH, WI 54956-4993
(614) 313-3149
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
73398-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2015
Last updated
10/10/2023
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