Healthcare Provider Details

I. General information

NPI: 1023577236
Provider Name (Legal Business Name): JENNIFER MICHELLE SATAR DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2019
Last Update Date: 09/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4910 VALLEY VIEW BLVD NW FL 3
ROANOKE VA
24012
US

IV. Provider business mailing address

1900 ELECTRIC RD
SALEM VA
24153-7474
US

V. Phone/Fax

Practice location:
  • Phone: 540-265-4210
  • Fax: 540-265-4219
Mailing address:
  • Phone: 540-776-4000
  • Fax: 540-265-4219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: