Provider Credentials
Dr. Uma Subramaniam M.D.
STATE LICENSE NUMBER
ALABAMA 37353 ARIZONA 57741 COLORADO CDR.0000257 FLORIDA ME129305 GEORGIA 77445 IDAHO MC-0100 ILLINOIS 036-116000 INDIANA 01082062A IOWA MD-36760 KANSAS 04-41418 KENTUCKY 49631 MAINE MD22522 MISSISSIPPI 26138 MONTANA 44495 NEBRASKA 31105 NEVADA 18466 NEW MEXICO MD2019-0102 NORTH CAROLINA 2019-00713 OKLAHOMA 34609 PENNSYLVANIA MD 459105 RHODE ISLAND MD16608 SOUTH DAKOTA 11226 TEXAS R 3600 UTAH 9849162-1205 WEST VIRGINIA 28680 WISCONSIN 65257-20 WYOMING 11868C
Dr. Sara Medunick D.O.
STATE LICENSE NUMBER
CALIFORNIA 20A15722 COLORADO 64200 KENTUCKY 04055 MISSOURI 2019005231 NEW JERSEY 25MB07846300 NEW YORK 286639 VIRGINIA 102204846 WISCONSIN 72318
Dr. Marc Serota M.D.
STATE LICENSE NUMBER
ALABAMA MD.36380 ARIZONA 55226 ARKANSAS E-13616 CALIFORNIA 162686 COLORADO 52146 CONNECTICUT 65167 DELAWARE C1-0023995 FLORIDA ME129254 GEORGIA 83502 HAWAII 19710 IDAHO MC-0044 ILLINOIS 36.145168 INDIANA 01083674A IOWA MD-45015 KANSAS 04-40730 KENTUCKY C0022 LOUISIANA 305644 MARYLAND D0088233 MICHIGAN EMC0000010 MISSISSIPPI 25653 MISSOURI 2016026398 MONTANA 66092 NEBRASKA 30666 NEVADA 17736 NEW HAMPSHIRE 18504 NEW JERSEY TL21 NEW MEXICO 2020-0286 NEW YORK 253165 NORTH CAROLINA 2019-02794 NORTH DAKOTA 15990 OHIO 35.138036 OKLAHOMA 35583 OREGON MD198021 PENNSYLVANIA 469816 RHODE ISLAND MD17024 SOUTH CAROLINA 83418 SOUTH DAKOTA 10824 TENNESSEE 60273 TEXAS R9280 UTAH 10744540-1205 VIRGINIA 101268839 WASHINGTON 60836458 WEST VIRGINIA 67965 - 20 WISCONSIN 28118 WYOMING 11410C
Dr. Laura Purdy M.D.
STATE LICENSE NUMBER
ALABAMA 38219 ALASKA 154787 ARIZONA 56179 ARKANSAS T2020-299 CALIFORNIA A 158424 COLORADO CDR 0000467 CONNECTICUT 61781 DELAWARE C1-0024357 FLORIDA ME137014 GEORGIA 69427 HAWAII MD-21807 IDAHO MC-0275 ILLINOIS 36144665 INDIANA 01078559A IOWA MD-46566 KANSAS 04-42519 KENTUCKY 50375 LOUISIANA 324749 MAINE MD22378 MARYLAND D86195 MASSACHUSETTS 282282 MICHIGAN EMC0000013 MINNESOTA 66206 MISSISSIPPI 25959 MISSOURI 2018030465 MONTANA MED-PHYS-LIC-78317 NEBRASKA 30509 NEVADA 18753 NEW HAMPSHIRE 19927 NEW JERSEY 25MA10869400 NEW MEXICO TM2020-0750 NEW YORK 302031 NORTH CAROLINA 2018-01536 NORTH DAKOTA 15937 OHIO 35.133756 OKLAHOMA 33235 OREGON MD207007 PENNSYLVANIA MD475082 RHODE ISLAND MD17084 SOUTH CAROLINA 52766 SOUTH DAKOTA 11690 TENNESSEE 55905 TEXAS S8483 UTAH 11418160-1205 VERMONT 042.0014659-COMP VIRGINIA 101263585 WASHINGTON MD60995742 WEST VIRGINIA 29240 WISCONSIN 582-320 WYOMING 12348C
Dr. Mary Clifton M.D.
STATE LICENSE NUMBER
ALASKA 130651 ARIZONA 52312 ARKANSAS E-11968 DELAWARE C1-0013013 GEORGIA 81260 INDIANA 01080936A IOWA MD-43243 KENTUCKY 51817 LOUISIANA 310561 MICHIGAN 4301065488 MINNESOTA 57187 NORTH CAROLINA 2018-02173 OREGON MD190663 SOUTH CAROLINA 61319 TEXAS R9345 VERMONT 42.0014271 WISCONSIN 61341
Dr. James Teet D.O.
STATE LICENSE NUMBER
ALABAMA 2611 ARIZONA 9744 ARKANSAS E-13592 CALIFORNIA 18647 COLORADO CDR.0001338 DELAWARE C2-0023864 DISTRICT OF COLUMBIA DO 034489 FLORIDA OS12767 GEORGIA 72832 IDAHO OC-0106 ILLINOIS 36.160567 INDIANA TS0000873 IOWA DO-06072 KANSAS TW-00019 KENTUCKY 03755 LOUISIANA 324567 MAINE DO3166 MARYLAND H90580 MICHIGAN 5101025908 MINNESOTA 71504 MISSISSIPPI 29437 MONTANA 1740576925 NEBRASKA 2298 NEVADA 1740576925 NEW HAMPSHIRE 16884 NEW JERSEY 25MB11199900 NEW YORK 267625 NORTH CAROLINA 2014-02010 NORTH DAKOTA 18451 OHIO 11517 OREGON DO201745 SOUTH CAROLINA DO 36750 SOUTH DAKOTA 12352 TENNESSEE 2729 TEXAS S8661 VIRGINIA 102203990 WASHINGTON OP61127003 WEST VIRGINIA 9216 WISCONSIN 1030-321
Dr. Niraj Govil M.D.
STATE LICENSE NUMBER
CALIFORNIA C 170146 FLORIDA ME147665 GEORGIA 89903 ILLINOIS 36157175 MICHIGAN 4301504807 NEW JERSEY 25MA06645400 NEW YORK 310455 OHIO 35.132613 PENNSYLVANIA MD474648 TEXAS S8709 VIRGINIA 101272297
Dr. Takashi Nakamura M.D.
STATE LICENSE NUMBER
ALABAMA 42886 ALASKA 177995 ARIZONA 62592 ARKANSAS E-13956 CALIFORNIA C171448 COLORADO CDR.0001224 CONNECTICUT 68598 DELAWARE C1-0024095 DISTRICT OF COLUMBIA MD048925 FLORIDA ME149982 GEORGIA 89670 HAWAII MD-17392 IDAHO MC-0962 ILLINOIS 36.157725 INDIANA 01085065A IOWA MD-48717 KANSAS 04-44955 KENTUCKY 55095 LOUISIANA 325538 MAINE MD25102 MARYLAND D0092140 MASSACHUSETTS 286609 MICHIGAN EMC0001161 MINNESOTA 69734 MISSISSIPPI 29144 MISSOURI 2021019466 MONTANA 100319 NEBRASKA 33727 NEVADA 20204 NEW HAMPSHIRE 21724 NEW JERSEY 25MA11074900 NEW MEXICO MD2021-0053 NEW YORK 308020 NORTH CAROLINA 2021-00321 NORTH DAKOTA 17592 OHIO 35.141118 OKLAHOMA 38560 OREGON MD202933 PENNSYLVANIA MD473025 RHODE ISLAND MD17720 SOUTH CAROLINA 85339 SOUTH DAKOTA 12874 TENNESSEE 64160 TEXAS T1483 UTAH 12385911-1205 VERMONT 42.0015426 VIRGINIA 101270202 WASHINGTON MD61124561 WEST VIRGINIA 30682 WISCONSIN 1416-320 WYOMING 13649C
Dr. Kei Kikuhara M.D.
STATE LICENSE NUMBER
ARIZONA 66603 CALIFORNIA C 178235 COLORADO DR.0068573 FLORIDA ME156709 HAWAII MD-17438 IDAHO M-16667 NEW MEXICO TM2022-0345 NEW YORK 315127 OHIO 35.144662 PENNSYLVANIA MD477762 VIRGINIA 101275198 WASHINGTON MD61293465
Dr. Gene Lee M.D.
STATE LICENSE NUMBER
ALABAMA 37951 ALASKA 138133 ARIZONA 58285 ARKANSAS E-11901 CALIFORNIA C160399 COLORADO CDR.0000310 CONNECTICUT 62119 DELAWARE C1-0005905 DISTRICT OF COLUMBIA MD046767 FLORIDA ME138265 GEORGIA 81898 HAWAII MD-20231 IDAHO MC-0177 ILLINOIS 036148529 INDIANA 01081614A IOWA MD-46010 KANSAS 04-41956 KENTUCKY 52005 LOUISIANA 311604 MAINE MD22941 MARYLAND D86530 MASSACHUSETTS 277657 MICHIGAN 4301116498 MINNESOTA 65068 MISSISSIPPI 26563 MISSOURI 2018038577 MONTANA MED-PHYS-LIC-72585 NEBRASKA 31534 NEVADA 18666 NEW HAMPSHIRE 19495 NEW JERSEY 25MA10473000 NEW MEXICO MD2018-0938 NEW YORK 296474 NORTH CAROLINA 2018-02806 NORTH DAKOTA 15483 OHIO 35.135148 OKLAHOMA 34331 OREGON MD190709 PENNSYLVANIA MD466320 RHODE ISLAND MD16467 SOUTH CAROLINA 81714 SOUTH DAKOTA 11373 TENNESSEE 58560 TEXAS S0003 UTAH 11176039-1205 VERMONT 042.0014222 VIRGINIA 0101265917 WASHINGTON MD60902200 WEST VIRGINIA 28819 WISCONSIN 352 WYOMING 12003C