Provider Demographics
NPI:1699771527
Name:MORISETTY, SATYASAGAR (MD)
Entity type:Individual
Prefix:
First Name:SATYASAGAR
Middle Name:
Last Name:MORISETTY
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 1:380 SUMMIT AVE
Mailing Address - Street 2:MSO PHYSICIAN BILLING
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2667
Mailing Address - Country:US
Mailing Address - Phone:740-283-7597
Mailing Address - Fax:740-283-7807
Practice Address - Street 1:401 MARKET ST STE 601
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2846
Practice Address - Country:US
Practice Address - Phone:740-314-5819
Practice Address - Fax:740-792-4473
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-24
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV21439207RP1001X
PAMD421673207RP1001X
OH35062048M207RP1001X
NY186554-1207RP1001X
NJ55696207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1012108920001Medicaid
OH2487456Medicaid
WV3000305000Medicaid
OHP00121410OtherRR MEDICARE
WVP00437973OtherRR MEDICARE
WVP00437973OtherRR MEDICARE
F09978Medicare UPIN
OH2487456Medicaid
OH4126691Medicare PIN
OHP00121410OtherRR MEDICARE
WV4126695Medicare PIN
WV4126694Medicare PIN
OH4126693Medicare PIN