Basic Information
| Provider Information | |||||||||
| NPI: | 1205908753 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SATORI MEDICAL CENTER, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 312 KING STREET | ||||||||
| Address2: | |||||||||
| City: | KEYSVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 239470360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4347368801 | ||||||||
| FaxNumber: | 4347360292 | ||||||||
| Practice Location | |||||||||
| Address1: | 312 KING ST. | ||||||||
| Address2: | |||||||||
| City: | KEYSVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 239473659 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4347368801 | ||||||||
| FaxNumber: | 4347360292 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/13/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | MOORE | ||||||||
| AuthorizedOfficialFirstName: | TERESA | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | DOCTOR, OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4347368801 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 0101052933 | VA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.