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General NPI Number Information
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NPI Number | 1093794950
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Entity Type | Individual
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Provider Name | EDWARD C SATHOFF MD
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Gender | Male
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Dates
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Enumeration Date | 01/10/2006
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Last Update Date | 07/15/2020
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Provider Practice Location Address
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Address Line | 1400 E MADISON AVE STE 352 MANKATO CLINIC DEPT OF PSYCHIATRY
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City | MANKATO
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State | MN
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Zip | 56001-5473
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Country | US
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Telephone | 507-387-3195
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8674 1230 E MAIN ST
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City | MANKATO
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State | MN
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Zip | 56002-8674
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Country | US
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Telephone | 507-625-1811
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 34673
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License Number State | MN
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