Provider Demographics
NPI:1083644249
Name:CHETI, SATYANARAYANA RAO (MD)
Entity Type:Individual
Prefix:MR
First Name:SATYANARAYANA
Middle Name:RAO
Last Name:CHETI
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4778 N HENRY BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-3566
Mailing Address - Country:US
Mailing Address - Phone:770-474-8781
Mailing Address - Fax:770-474-8670
Practice Address - Street 1:4778 N HENRY BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-3566
Practice Address - Country:US
Practice Address - Phone:770-474-8781
Practice Address - Fax:770-474-8670
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA042211207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000716647HMedicaid
GAG41769Medicare UPIN
GA000716647HMedicaid