MEDICARE: DR. LATHA SUBRAMANIAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0000X	Hematology (Internal Medicine) Physician	AA2285	AK
2	207RH0003X	Hematology & Oncology Physician	AA2285	AK
3	207RX0202X	Medical Oncology Physician	AA2285	AK
4	174400000X	Specialist	AA2285	AK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AA2285	OTHER	AK	STATE LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841262201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LATHA SUBRAMANIAN M.D.

Provider Business Mailing Address
First Line	:	4048 LAUREL ST
Second Line	:	STE 305
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5391
Country	:	US
Telephone Number	:	907-569-2627
Fax Number	:	907-569-2626

Provider Business Practice Location Address
First Line	:	4048 LAUREL ST
Second Line	:	STE 305
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5391
Country	:	US
Telephone Number	:	907-569-2627
Fax Number	:	907-569-2626

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2006
Last Update Date	:	03/07/2023

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