Provider Demographics
NPI:1811947369
Name:PATHAK, SATISH K (MD)
Entity type:Individual
Prefix:
First Name:SATISH
Middle Name:K
Last Name:PATHAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 91734
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23291-1734
Mailing Address - Country:US
Mailing Address - Phone:804-358-6100
Mailing Address - Fax:804-342-7619
Practice Address - Street 1:1250 E MARSHALL ST
Practice Address - Street 2:DEPT. OF IM-CARDIOLOGY
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5051
Practice Address - Country:US
Practice Address - Phone:804-526-0682
Practice Address - Fax:804-526-6561
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101049073207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA017897V69Medicare PIN
VA1811947369Medicaid
VA060044030OtherMEDICARE RAILROAD PIN
VAF46010Medicare UPIN
VA5803314Medicaid
VAVAA102476Medicare PIN