Individual
SATISH P SHANBHAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD,MPH
Contact information
Practice address
2370 MARKET DR, FLEMING ISLAND, FL 32003-4326
(904) 264-6201
(904) 264-6858
Mailing address
7015 A C SKINNER PKWY STE 1, JACKSONVILLE, FL 32256-6932
(904) 363-2113
(904) 363-2606
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
L2568
AL
207RH0003X
Hematology & Oncology Physician
D70907
MD
207RH0003X
Hematology & Oncology Physician
Primary
ME143428
FL
207RH0003X
Hematology & Oncology Physician
MT191302
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105246400
—
FL
05
—
652111800
—
MD
01
—
L3890
MEDICARE
FL
01
—
NHFDE
FLORIDA BLUE
FL
01
—
P02444215
RAILROAD MEDICARE
FL
Enumeration date
05/07/2007
Last updated
05/14/2020
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