Provider Demographics
NPI:1366410623
Name:SATTERFIELD, GROVA LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:GROVA
Middle Name:LYNN
Last Name:SATTERFIELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:667 LANIER PARK DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-2059
Mailing Address - Country:US
Mailing Address - Phone:770-532-7501
Mailing Address - Fax:770-532-8322
Practice Address - Street 1:667 LANIER PARK DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-2059
Practice Address - Country:US
Practice Address - Phone:770-532-7501
Practice Address - Fax:770-532-8322
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA031822207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA395202OtherBLUE CROSS BLUE SHIELD
GAP00272011OtherRAILROAD MEDICARE
GA11BDKGVMedicare ID - Type Unspecified
GAP00272011OtherRAILROAD MEDICARE