Provider Demographics
NPI:1154551554
Name:SATTAR, AHSAN (MD)
Entity type:Individual
Prefix:
First Name:AHSAN
Middle Name:
Last Name:SATTAR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:804 SERVICE RD
Mailing Address - Street 2:A201
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824-7015
Mailing Address - Country:US
Mailing Address - Phone:517-884-2976
Mailing Address - Fax:517-432-3928
Practice Address - Street 1:804 SERVICE RD
Practice Address - Street 2:A217
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48824-7015
Practice Address - Country:US
Practice Address - Phone:517-353-8122
Practice Address - Fax:517-432-3713
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2016-06-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI556262084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1154551554Medicaid
MI1154551554Medicaid