Provider Demographics
NPI:1194832758
Name:SATHIRAJU, SARVESH RAO (MD)
Entity Type:Individual
Prefix:DR
First Name:SARVESH
Middle Name:RAO
Last Name:SATHIRAJU
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 1:560 MALCOLM BLVD
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD COLLEGE
Mailing Address - State:NC
Mailing Address - Zip Code:28671-0848
Mailing Address - Country:US
Mailing Address - Phone:828-879-3400
Mailing Address - Fax:
Practice Address - Street 1:560 MALCOLM BLVD
Practice Address - Street 2:
Practice Address - City:RUTHERFORD COLLEGE
Practice Address - State:NC
Practice Address - Zip Code:28671-0848
Practice Address - Country:US
Practice Address - Phone:828-879-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9901311207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89133WUMedicaid
NC89133WUMedicaid