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General NPI Number Information
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NPI Number | 1871151753
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Entity Type | Individual
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Provider Name | RYAN SATTAR DNP
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Gender | Male
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Dates
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Enumeration Date | 06/05/2019
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Last Update Date | 11/02/2022
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Provider Practice Location Address
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Address Line | 700 PLAZA CIR STE N
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City | CLINTON
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State | SC
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Zip | 29325-7556
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Country | US
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Telephone | 864-547-2160
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Fax | 864-547-2159
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Provider Business Mailing Address
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Address Line | 700 PLAZA CIR STE N
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City | CLINTON
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State | SC
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Zip | 29325-7556
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Country | US
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Telephone | 706-503-5030
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 216987
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 22986
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License Number State | SC
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