Healthcare Provider Details

I. General information

NPI: 1174543805
Provider Name (Legal Business Name): RICHARD A. SATER MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 09/20/2021
Certification Date: 09/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

912 3RD ST STE 101
GREENSBORO NC
27405
US

IV. Provider business mailing address

912 3RD ST STE 101
GREENSBORO NC
27405-6967
US

V. Phone/Fax

Practice location:
  • Phone: 336-273-2511
  • Fax: 336-370-0287
Mailing address:
  • Phone: 336-273-2511
  • Fax: 336-370-0287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number9801049
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number9801049
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number9801049
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number9801049
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: