Basic Information
| Provider Information | |||||||||
| NPI: | 1205897774 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | GHOSH | ||||||||
| FirstName: | SUBHA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8031 CRAGINHALL LN | ||||||||
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| City: | DUBLIN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430178596 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1654 UPHAM DR | ||||||||
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| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432101250 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6147842305 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2006 | ||||||||
| LastUpdateDate: | 04/27/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 35.092068 | OH | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.