Provider Demographics
NPI:1093723629
Name:SATCHER, SERENA (MD)
Entity Type:Individual
Prefix:
First Name:SERENA
Middle Name:
Last Name:SATCHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 PEACHTREE ST NW STE 2200
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-1292
Mailing Address - Country:US
Mailing Address - Phone:703-454-9326
Mailing Address - Fax:866-849-0847
Practice Address - Street 1:260 PEACHTREE ST NW STE 2200
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-1292
Practice Address - Country:US
Practice Address - Phone:703-454-9326
Practice Address - Fax:866-849-0847
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA055442202D00000X, 207R00000X, 208100000X
VA0101249229202D00000X, 207R00000X, 208100000X, 202C00000X
IL036-086485207R00000X, 208100000X
NY255199-1208100000X
GA0554442208100000X, 202C00000X
NY0101249229208100000X
NY255199202C00000X
NJ25MA08680800208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No202D00000XAllopathic & Osteopathic PhysiciansIntegrative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No202C00000XAllopathic & Osteopathic PhysiciansIndependent Medical Examiner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036086485Medicaid
IL250012434OtherRAILROAD MEDICARE
IL250012433OtherRAILROAD MEDICARE
F37405Medicare UPIN
ILL83035Medicare PIN
IL250012433OtherRAILROAD MEDICARE
IL036086485Medicaid