Provider Demographics
NPI:1770677742
Name:SATTMAN, GARY LEE (DO)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:LEE
Last Name:SATTMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:208 W ST LOUIS ST
Mailing Address - Street 2:
Mailing Address - City:PACIFIC
Mailing Address - State:MO
Mailing Address - Zip Code:63069-1499
Mailing Address - Country:US
Mailing Address - Phone:636-271-2520
Mailing Address - Fax:636-257-4304
Practice Address - Street 1:208 W ST LOUIS ST
Practice Address - Street 2:
Practice Address - City:PACIFIC
Practice Address - State:MO
Practice Address - Zip Code:63069-1499
Practice Address - Country:US
Practice Address - Phone:636-271-2520
Practice Address - Fax:636-257-4304
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO31197207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0100182OtherUNITED HEALTH CARE
46754OtherGROUP HEALTH PLAN
5500000006559122OtherDCN NATIONAL PRACTITIONER
I4600OtherPRINCIPAL HEALTH CARE
104642OtherHEALTHLINK
MO25503OtherBLUE CROSS BLUE SHIELD
4082910OtherAETNA US HEALTHCARE
46754OtherGROUP HEALTH PLAN
MO00006473Medicare ID - Type Unspecified