Provider Demographics
NPI:1184637027
Name:SATTERLEY, MICHAEL (PT,DPT,SCS,CIMT,CMTP)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:SATTERLEY
Suffix:
Gender:M
Credentials:PT,DPT,SCS,CIMT,CMTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 69030
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-9030
Mailing Address - Country:US
Mailing Address - Phone:757-873-2302
Mailing Address - Fax:757-873-2306
Practice Address - Street 1:751 J CLYDE MORRIS BLVD
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601-1538
Practice Address - Country:US
Practice Address - Phone:757-873-2123
Practice Address - Fax:757-873-3848
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305204715225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010296731Medicaid
VA7166869OtherAETNA
VA192933OtherBCBS PHYSICAL THERAPY
VAP00361692OtherRAILROAD MEDICARE
VAC05954Medicare PIN
VA010296731Medicaid