Provider Demographics
NPI:1033177852
Name:SATYAL, SHARAD R (M D)
Entity Type:Individual
Prefix:
First Name:SHARAD
Middle Name:R
Last Name:SATYAL
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914A EASTERN SHORE DR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-6410
Mailing Address - Country:US
Mailing Address - Phone:410-546-1331
Mailing Address - Fax:410-543-8107
Practice Address - Street 1:910 EASTERN SHORE DR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-6410
Practice Address - Country:US
Practice Address - Phone:410-546-1331
Practice Address - Fax:410-543-8107
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0062172207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD406440200Medicaid
MD837MJ910Medicare ID - Type Unspecified
MD406440200Medicaid