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General NPI Number Information
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NPI Number | 1558535401
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Entity Type | Individual
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Provider Name | SHANKAR THIRUTHURAIPOONDI SUBBIAH
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Gender | Male
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Dates
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Enumeration Date | 04/22/2008
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 1341 WRIGHT AVE
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City | ALMA
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State | MI
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Zip | 48801-1134
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Country | US
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Telephone | 989-463-6111
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Fax |
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Provider Business Mailing Address
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Address Line | 2900 GREYSTONE LN APT 17
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City | MT PLEASANT
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State | MI
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Zip | 48858-8453
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Country | US
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Telephone | 989-779-0571
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302036585
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License Number State | MI
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