Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Suba Pathmanathan, MD

Individual provider Internal Medicine Physician · NPI 1205191871

Dr. Suba Pathmanathan, MD is an Internal Medicine in Newark, Ohio. Qualified in 2007, 19 years ago. Practices with Licking Memorial Professional Corporation, a 235-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Michigan, Minnesota and Ohio.

Years since qualifying
19
Licensed in
MI, MN, OH
In the registry since
2012
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

120 McMillen Dr
Newark, OH 43055-1809
Phone: (220) 564-4805
Fax: (220) 564-4811
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 35.141212 (OH)
Internal Medicine Physician Taxonomy 207R00000X · Licence 66234 (MN)
Internal Medicine Physician Taxonomy 207R00000X · Licence 4301100221 (MI)

Record details

NPI number1205191871
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 10, 2012
Last updated in NPPESMay 26, 2023
Certification dateMay 26, 2023
Mailing address120 McMillen Dr, Newark, OH 43055-1809

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Licking Memorial Professional Corporation — 235 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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