Healthcare Provider Details

I. General information

NPI: 1205908753
Provider Name (Legal Business Name): SATORI MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 KING ST.
KEYSVILLE VA
23947-3659
US

IV. Provider business mailing address

312 KING STREET
KEYSVILLE VA
23947-0360
US

V. Phone/Fax

Practice location:
  • Phone: 434-736-8801
  • Fax: 434-736-0292
Mailing address:
  • Phone: 434-736-8801
  • Fax: 434-736-0292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101052933
License Number StateVA

VIII. Authorized Official

Name: DR. TERESA A MOORE
Title or Position: DOCTOR, OWNER
Credential: M.D.
Phone: 434-736-8801