Provider Demographics
NPI:1639389323
Name:SATTAR, JOANNA QIONG (MD)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:QIONG
Last Name:SATTAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:QIONG
Other - Last Name:WU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6050 GREENFIELD RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-6004
Mailing Address - Country:US
Mailing Address - Phone:313-945-9000
Mailing Address - Fax:
Practice Address - Street 1:6050 GREENFIELD RD
Practice Address - Street 2:SUITE 101
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-6004
Practice Address - Country:US
Practice Address - Phone:313-945-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301091158207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine