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Individual

CARLOS SUBAUSTE

Active
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Individual

CARLOS SUBAUSTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35072126
OH
207RI0200X
Infectious Disease Physician
Primary
35072126
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000224445
UNISON
OH
01
000000539608
ANTHEM
OH
05
2044095
OH
01
364064
WELLCARE
OH
01
5606609
AETNA
OH
01
751186
BUCKEYE
OH
01
P00620405
RAILROAD MEDICARE
OH
Enumeration date
07/03/2006
Last updated
12/17/2020
Update your record

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