Healthcare Provider Details

I. General information

NPI: 1467014399
Provider Name (Legal Business Name): KAMAL RAJ SUBEDI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2019
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 SCOTLAND AVE
CHAMBERSBURG PA
17201-1451
US

IV. Provider business mailing address

601 MEMORY LN
YORK PA
17402-2231
US

V. Phone/Fax

Practice location:
  • Phone: 717-217-6055
  • Fax: 717-839-6593
Mailing address:
  • Phone: 717-217-6055
  • Fax: 717-217-4329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD478394
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: