Provider Demographics
NPI:1922302918
Name:POTLURI, SATYA (MD)
Entity Type:Individual
Prefix:
First Name:SATYA
Middle Name:
Last Name:POTLURI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2575 NORTHWINDS PKWY
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-2232
Mailing Address - Country:US
Mailing Address - Phone:678-690-7688
Mailing Address - Fax:
Practice Address - Street 1:10101 SE MAIN ST STE 2011
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97216-2457
Practice Address - Country:US
Practice Address - Phone:503-261-6912
Practice Address - Fax:503-251-6357
Is Sole Proprietor?:No
Enumeration Date:2011-01-05
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA313085207RE0101X
PAMD459790207RE0101X
ORMD212593207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism