Individual
ASMITHA KATHLEEN SATHIYAKUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1403 OLD WATER WORKS RD SW, FORT PAYNE, AL 35968-3353
(256) 646-7246
Mailing address
1825 GLENN BLVD SW STE 343, FORT PAYNE, AL 35968-3533
(256) 646-7246
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
075665
GA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD47655
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G041212248
MEDICARE PTAN
GA
01
—
MD47655
ALABAMA STATE LICENSE
AL
01
—
P02289708
RRMEDICARE PTAN
GA
Enumeration date
04/02/2012
Last updated
05/06/2024
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