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Individual

DR. SATISH JAGAN MOHAN BANKURU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
1750 THOMPSON RD, COOS BAY, OR 97420-2100
(541) 269-0333
Mailing address
1750 THOMPSON RD, COOS BAY, OR 97420-2100
(541) 269-0333

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301098724
MI
207R00000X
Internal Medicine Physician
Primary
MD165899
OR

Other

Enumeration date
06/04/2011
Last updated
08/11/2014
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