Provider Demographics
NPI:1639198856
Name:PATTEM, SANDHYA (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDHYA
Middle Name:
Last Name:PATTEM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 TONEY PENNA DR STE 101
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-5747
Mailing Address - Country:US
Mailing Address - Phone:561-746-2033
Mailing Address - Fax:
Practice Address - Street 1:175 TONEY PENNA DR STE 101
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-5747
Practice Address - Country:US
Practice Address - Phone:561-746-2033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA071270207Q00000X
SC28885207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAA15199640Medicare UPIN