Individual
DASA SATYAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
468 NORTHAMPTON ST, EDWARDSVILLE, PA 18704-4566
(570) 718-1307
Mailing address
PO BOX 1023, KINGSTON, PA 18704-0023
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
MD036767L
PA
Other
Enumeration date
05/11/2006
Last updated
05/24/2021
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