Provider Demographics
NPI:1942314604
Name:SATTAR, SYED P (MD)
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:P
Last Name:SATTAR
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 1:2808 N 75TH ST
Mailing Address - Street 2:SUITE H
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-6861
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3528 DODGE ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-3202
Practice Address - Country:US
Practice Address - Phone:402-345-8828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE218232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1942314604Medicaid
NE100258857700Medicaid
NE10025068600Medicaid
NE10025068600Medicaid
NE093285Medicare PIN
IA08871006Medicare PIN
NE275322Medicare PIN