Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | MD163821 | OR |
N | 207R00000X | Internist | MD163821 | OR |
N | 111NI0900X | Internist | MD163821 | OR |
N | 207RG0300X | Geriatric Medicine | MD163821 | OR |
NPI | 1063641744 |
---|---|
Provider Name | Preeti Satyanarayana |
First Address | Roseburg, OR 97471-8857 |
Second Address | Roseburg, OR 97471-1281 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2009 |
Last Update Date | 30/09/2017 |