Provider Demographics
NPI:1518675149
Name:SATHER, JAY (MD)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:
Last Name:SATHER
Suffix:
Gender:M
Credentials:MD
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:12815 ARBOR LAKES PKWY N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-7060
Mailing Address - Country:US
Mailing Address - Phone:763-257-2917
Mailing Address - Fax:
Practice Address - Street 1:6200 EXCELSIOR BLVD STE 202
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-2734
Practice Address - Country:US
Practice Address - Phone:952-548-9340
Practice Address - Fax:952-548-9350
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN31153207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine