Provider Demographics
NPI:1518993997
Name:BHADRIRAJU, SATISH (MD)
Entity Type:Individual
Prefix:
First Name:SATISH
Middle Name:
Last Name:BHADRIRAJU
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 1:6600 S YALE AVE STE 1200
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3333
Mailing Address - Country:US
Mailing Address - Phone:918-488-6687
Mailing Address - Fax:918-488-6098
Practice Address - Street 1:6585 S YALE AVE STE 650
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-8319
Practice Address - Country:US
Practice Address - Phone:918-502-5600
Practice Address - Fax:918-502-5603
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK31260207RS0012X, 208M00000X
TXP6143207R00000X
GA60351208M00000X
AR13924207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP01296600 (MDACC)OtherRR MEDICARE
TX8EE282OtherBCBS (MDACC)
TX334834401 (MDACC)Medicaid
TX332917YKQH (MDACC)Medicare PIN
TX8EE282OtherBCBS (MDACC)