Provider Demographics
NPI:1528092475
Name:SATTER, PAUL ANTHONY (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ANTHONY
Last Name:SATTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 N 100 E
Mailing Address - Street 2:
Mailing Address - City:TOOELE
Mailing Address - State:UT
Mailing Address - Zip Code:84074-2101
Mailing Address - Country:US
Mailing Address - Phone:435-882-6618
Mailing Address - Fax:435-843-3774
Practice Address - Street 1:15 N 100 E
Practice Address - Street 2:
Practice Address - City:TOOELE
Practice Address - State:UT
Practice Address - Zip Code:84074-2101
Practice Address - Country:US
Practice Address - Phone:435-882-6618
Practice Address - Fax:435-843-3774
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2807191205174400000X
UT280719-1205208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTG37625Medicare UPIN
UT005715601Medicare ID - Type UnspecifiedPROVIDER ID NUMBER