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Organization
KEYSTONE PAIN CENTER LLC
Active
Organization
KEYSTONE PAIN CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DASA SATYAM MD (PHYSICIAN)
(570) 718-1307
Entity
Organization
Contact information
Practice address
468 NORTHAMPTON ST, EDWARDSVILLE, PA 18704-4566
(570) 718-1307
(570) 718-1309
Mailing address
415 N MAIN ST, WILKES BARRE, PA 18702-4411
(570) 208-5571
(570) 208-5548
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MD036737L
PA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD036737L
PA
Other
Enumeration date
02/27/2008
Last updated
05/22/2008
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