Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 35071157 | OH |
NPI | 1265411243 |
---|---|
Provider Name | Srinivasa Satti |
First Address | Canton, OH 44710-1702 |
Second Address | Canton, OH 44710-1702 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2006 |
Last Update Date | 15/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H57969 | (02) | OH |