Provider Demographics
NPI:1851344774
Name:SATYAM, VENKATA G (MD)
Entity Type:Individual
Prefix:
First Name:VENKATA
Middle Name:G
Last Name:SATYAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:228 BILLERICA RD
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-3604
Mailing Address - Country:US
Mailing Address - Phone:978-250-6100
Mailing Address - Fax:978-250-6470
Practice Address - Street 1:228 BILLERICA RD
Practice Address - Street 2:INTERNAL MEDICINE
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-3604
Practice Address - Country:US
Practice Address - Phone:978-250-6100
Practice Address - Fax:978-250-6470
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA53327207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3193527Medicaid
MAE10395Medicare UPIN
MAJ08681Medicare PIN