Provider Demographics
NPI:1538574314
Name:SATYARENGGA, MEDHA (MD)
Entity type:Individual
Prefix:DR
First Name:MEDHA
Middle Name:
Last Name:SATYARENGGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1140 BLADES FARM RD STE 101
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21629-3488
Mailing Address - Country:US
Mailing Address - Phone:410-822-1000
Mailing Address - Fax:410-822-5117
Practice Address - Street 1:1140 BLADES FARM RD STE 101
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:MD
Practice Address - Zip Code:21629
Practice Address - Country:US
Practice Address - Phone:410-822-1000
Practice Address - Fax:410-822-5117
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-30
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD87509207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine