Provider Demographics
NPI:1053105429
Name:NAGELLI, SATISH BABU (PA-C)
Entity type:Individual
Prefix:DR
First Name:SATISH
Middle Name:BABU
Last Name:NAGELLI
Suffix:
Gender:
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:39393 VAN DYKE AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48313-4636
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:39393 VAN DYKE AVE STE 101
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48313-4636
Practice Address - Country:US
Practice Address - Phone:313-403-8787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant