Healthcare Provider Details

I. General information

NPI: 1912206020
Provider Name (Legal Business Name): SATHYANARAYANA MACHANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2011
Last Update Date: 12/04/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 FIFTH AVE INTERNAL MEDICINE
MCKEESPORT PA
15132-2403
US

IV. Provider business mailing address

1321 FIFTH AVE INTERNAL MEDICINE
MCKEESPORT PA
15132-2403
US

V. Phone/Fax

Practice location:
  • Phone: 412-664-2782
  • Fax: 412-664-2784
Mailing address:
  • Phone: 412-664-2782
  • Fax: 412-664-2784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberRL11495
License Number StateND
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD487080
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number26477
License Number StateWV
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number12803
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: