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General NPI Number Information
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NPI Number | 1003874306
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Entity Type | Individual
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Provider Name | SUBRATA P BARUA M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 02/05/2010
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Provider Practice Location Address
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Address Line | RR 6 WALTON TEA ROOM ROAD
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City | GREENSBURG
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State | PA
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Zip | 15601-9806
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Country | US
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Telephone | 724-527-5959
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Fax | 724-523-5135
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Provider Business Mailing Address
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Address Line | RR 6 WALTON TEA ROOM ROAD
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City | GREENSBURG
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State | PA
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Zip | 15601-9806
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Country | US
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Telephone | 724-527-5959
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Fax | 724-523-5135
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD032012L
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License Number State | PA
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