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NPI 1003095654

NPI 1003095654 : SATISH KENCHAIAH MD, MPH : INDIANAPOLIS, IN

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General NPI Number Information
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    NPI Number           |    1003095654
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    Entity Type          |    Individual 
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    Provider Name        |    SATISH KENCHAIAH MD, MPH
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/31/2007
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    Last Update Date     |    06/30/2025
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Provider Practice Location Address
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    Address Line         |    1481 W 10TH ST 
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    City                 |    INDIANAPOLIS
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    State                |    IN
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    Zip                  |    46202-2803
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    Country              |    US
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    Telephone            |    317-988-4989
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1481 W 10TH ST 
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    City                 |    INDIANAPOLIS
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    State                |    IN
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    Zip                  |    46202-2803
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    Country              |    US
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    Telephone            |    317-988-4989
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207RC0000X
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    Taxonomy Name        |    Cardiovascular Disease Physician
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    License Number       |    290394
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    License Number State |    NY
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