Healthcare Provider Details
I. General information
NPI: 1013965185
Provider Name (Legal Business Name): JUSTIN ALAN SATTIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/04/2006
Last Update Date: 01/26/2021
Certification Date: 01/26/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
600 HIGHLAND AVE
MADISON WI
53792-0001
US
IV. Provider business mailing address
7974 UW HEALTH CT
MIDDLETON WI
53562-5531
US
V. Phone/Fax
- Phone: 608-263-5442
- Fax: 608-265-1753
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084V0102X |
| Taxonomy | Vascular Neurology Physician |
| License Number | 49369 |
| License Number State | WI |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | 49369 |
| License Number State | WI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: