Basic Information
| Provider Information | |||||||||
| NPI: | 1700185089 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SATAPATHY | ||||||||
| FirstName: | SANJAYA | ||||||||
| MiddleName: | KUMAR | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1407 UNION AVE | ||||||||
| Address2: | SUITE 640 | ||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381043627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9018668372 | ||||||||
| FaxNumber: | 9013022372 | ||||||||
| Practice Location | |||||||||
| Address1: | 1407 UNION AVE | ||||||||
| Address2: | SUITE 640 | ||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381043627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9018668813 | ||||||||
| FaxNumber: | 9013022120 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/25/2011 | ||||||||
| LastUpdateDate: | 11/11/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | MD0000047432 | TN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 207RI0008X | MD0000047432 | TN | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hepatology | 207RT0003X | MD0000047432 | TN | N | Allopathic & Osteopathic Physicians | Internal Medicine | Transplant Hepatology |
No ID Information.