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General NPI Number Information
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NPI Number | 1962791632
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Entity Type | Individual
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Provider Name | DR. RISHI SUBBARAYAN
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Gender | Male
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Dates
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Enumeration Date | 04/04/2011
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 2000 E MILESTONE DR
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City | APPLETON
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State | WI
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Zip | 54913-6701
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Country | US
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Telephone | 920-731-8131
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Fax | 920-832-0444
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Provider Business Mailing Address
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Address Line | 2000 E MILESTONE DR
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City | APPLETON
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State | WI
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Zip | 54913-6701
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Country | US
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Telephone | 920-731-8131
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Fax | 920-832-0444
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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 | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | MD174080
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 60926-20
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License Number State | WI
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