Individual
MR. WITTAYA MICHAEL SATTASIRI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
808 S JAMES M CAMPBELL BLVD, COLUMBIA, TN 38401-4338
(407) 788-1906
Mailing address
PO BOX 305172 DEPT 163, NASHVILLE, TN 37230-5172
(407) 788-1906
(407) 865-6406
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD0000037469
TN
2085R0001X
Radiation Oncology Physician
Primary
MD0000037469
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4113874
BLUE CROSS BLUE SHIELD
TN
05
—
4113874
—
TN
Enumeration date
09/25/2006
Last updated
01/04/2023
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