Provider Demographics
NPI:1861467581
Name:VISWANATH, SATHYAMURTHY (MD)
Entity Type:Individual
Prefix:DR
First Name:SATHYAMURTHY
Middle Name:
Last Name:VISWANATH
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 1:1843 QUIET CV
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3857
Mailing Address - Country:US
Mailing Address - Phone:910-483-8080
Mailing Address - Fax:910-483-3258
Practice Address - Street 1:1843 QUIET COVE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3857
Practice Address - Country:US
Practice Address - Phone:910-483-8080
Practice Address - Fax:910-483-3258
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD426836207R00000X
NC200600580207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC142M4OtherBCBS
BV9323293OtherDEA
I34121Medicare UPIN