Basic Information
| Provider Information | |||||||||
| NPI: | 1134475114 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SATYANARAYANA | ||||||||
| FirstName: | PRERNA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1300 MICCOSUKEE RD | ||||||||
| Address2: | TALLAHASSEE MEMORIAL HOSPITALISTS GROUP | ||||||||
| City: | TALLAHASSEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 323085054 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8504314556 | ||||||||
| FaxNumber: | 8504316315 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 NORTHSIDE FORSYTH DR | ||||||||
| Address2: | |||||||||
| City: | CUMMING | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300417659 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7708443200 | ||||||||
| FaxNumber: | 7708443227 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2012 | ||||||||
| LastUpdateDate: | 01/10/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME125371 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 078395 | GA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 78395 | GA | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.