Provider Demographics
NPI:1023577236
Name:SATAR, JENNIFER MICHELLE (DO)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MICHELLE
Last Name:SATAR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 ELECTRIC RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-7474
Mailing Address - Country:US
Mailing Address - Phone:540-776-4000
Mailing Address - Fax:540-265-4219
Practice Address - Street 1:4910 VALLEY VIEW BLVD NW FL 3
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24012
Practice Address - Country:US
Practice Address - Phone:540-265-4210
Practice Address - Fax:540-265-4219
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-18
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program