Healthcare Provider Details

I. General information

NPI: 1093712804
Provider Name (Legal Business Name): SATISH N. KAMATH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 10/10/2012
Certification Date:
Deactivation Date: 03/21/2006
Reactivation Date: 03/27/2006

III. Provider practice location address

24100 OXFORD ST
DEARBORN MI
48124-2481
US

IV. Provider business mailing address

5195 RECTOR CT
BLOOMFIELD HILLS MI
48302-2655
US

V. Phone/Fax

Practice location:
  • Phone: 313-274-2500
  • Fax: 313-274-7805
Mailing address:
  • Phone: 248-855-6145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number037671
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: