Provider Demographics
NPI:1356421085
Name:GREWAL, SATKIRAN S (MD)
Entity type:Individual
Prefix:
First Name:SATKIRAN
Middle Name:S
Last Name:GREWAL
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 1:85 GILLETT ST STE 307
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-2630
Mailing Address - Country:US
Mailing Address - Phone:860-461-1151
Mailing Address - Fax:
Practice Address - Street 1:900 MEMORIAL AVE
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-3557
Practice Address - Country:US
Practice Address - Phone:413-788-0100
Practice Address - Fax:413-736-1723
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD4839772083A0300X
VA01012795182083A0300X
MA2264892083A0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine