Provider Demographics
NPI:1164790879
Name:SAKATI, ISAM AWNI (MD)
Entity Type:Individual
Prefix:DR
First Name:ISAM
Middle Name:AWNI
Last Name:SAKATI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 CLUB COURSE DR
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD
Mailing Address - State:SC
Mailing Address - Zip Code:29928-3127
Mailing Address - Country:US
Mailing Address - Phone:843-671-7682
Mailing Address - Fax:
Practice Address - Street 1:99 CLUB COURSE DR
Practice Address - Street 2:
Practice Address - City:HILTON HEAD
Practice Address - State:SC
Practice Address - Zip Code:29928-3127
Practice Address - Country:US
Practice Address - Phone:843-671-7682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-08
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20-19219208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology