Individual
DR. SATISH BABU KANAKAMEDALA
Active
Individual
DR. SATISH BABU KANAKAMEDALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD47704L
PA
207RG0100X
Gastroenterology Physician
Primary
MD047704L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000004793
BLUE SHIELD
PA
05
—
0014251780005
—
PA
01
—
10723709
CAQH
—
Enumeration date
02/10/2006
Last updated
03/08/2023
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