1134184567 NPI number — DR. SATYAJEET Y GAEKWAD M.D.

Table of content: DR. SATYAJEET Y GAEKWAD M.D. (NPI 1134184567)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134184567 NPI number — DR. SATYAJEET Y GAEKWAD M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GAEKWAD
Provider First Name:
SATYAJEET
Provider Middle Name:
Y
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134184567
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/05/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
705 ELM ST SW
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
ALBANY
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97321-1956
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-812-4580
Provider Business Mailing Address Fax Number:
541-928-3169

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
705 ELM ST SW
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
ALBANY
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97321-1956
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-812-4580
Provider Business Practice Location Address Fax Number:
541-928-3169
Provider Enumeration Date:
04/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  426885 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , with the licence number: MD26995 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100288230A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com