Provider Demographics
NPI:1790719698
Name:SATYANARAYAN, VISWESVAR (MD)
Entity Type:Individual
Prefix:DR
First Name:VISWESVAR
Middle Name:
Last Name:SATYANARAYAN
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:PO BOX 37
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38557-0037
Mailing Address - Country:US
Mailing Address - Phone:931-484-1100
Mailing Address - Fax:931-456-8821
Practice Address - Street 1:15 WALKER HILL CIRCLE
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555
Practice Address - Country:US
Practice Address - Phone:931-484-1100
Practice Address - Fax:931-456-8821
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD024150208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNF48870Medicare UPIN
TN3826551Medicare ID - Type Unspecified