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General NPI Number Information
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NPI Number | 1053606426
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Entity Type | Individual
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Provider Name | SUBASH ALA MD
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Gender | Male
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Dates
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Enumeration Date | 06/14/2011
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 142 S MAIN ST
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City | DANVILLE
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State | VA
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Zip | 24541-2922
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Country | US
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Telephone | 434-799-2225
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Fax |
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Provider Business Mailing Address
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Address Line | 1010 N. KANSAS WCGME
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City | WICHITA
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State | KS
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Zip | 67214
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Country | US
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Telephone | 316-268-5000
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101259294
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 0101259294
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 7598
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License Number State | KS
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