Healthcare Provider Details

I. General information

NPI: 1215903653
Provider Name (Legal Business Name): SUBASH BABU DUGGIRALA M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1406 WOODWELL RD
SILVER SPRING MD
20906-2080
US

IV. Provider business mailing address

1406 WOODWELL RD
SILVER SPRING MD
20906-2080
US

V. Phone/Fax

Practice location:
  • Phone: 240-476-1884
  • Fax:
Mailing address:
  • Phone: 240-476-1884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberD36726
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: