Provider Demographics
NPI:1831374743
Name:COLUMBIA CANCER INSTITUE INC
Entity type:Organization
Organization Name:COLUMBIA CANCER INSTITUE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SATTASIRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-380-4057
Mailing Address - Street 1:PO BOX 158
Mailing Address - Street 2:
Mailing Address - City:HOHENWALD
Mailing Address - State:TN
Mailing Address - Zip Code:38462-0158
Mailing Address - Country:US
Mailing Address - Phone:931-796-7881
Mailing Address - Fax:931-796-7379
Practice Address - Street 1:1224 TROTWOOD AVE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4802
Practice Address - Country:US
Practice Address - Phone:931-380-4057
Practice Address - Fax:931-540-4224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3731439OtherMEDICARE GROUP ID