Provider Demographics
NPI:1356503593
Name:AGRAWAL, SATYANISTH TANDON (DO)
Entity type:Individual
Prefix:
First Name:SATYANISTH
Middle Name:TANDON
Last Name:AGRAWAL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:190 CAMPUS BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2872
Mailing Address - Country:US
Mailing Address - Phone:540-667-1244
Mailing Address - Fax:540-667-3086
Practice Address - Street 1:824 N MILITARY HWY STE 100
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3652
Practice Address - Country:US
Practice Address - Phone:888-236-2263
Practice Address - Fax:757-390-4551
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC93564207RG0100X
VA0102206444207RG0100X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology