Provider Demographics
NPI:1992810550
Name:ANGRA, SATISH K (MD)
Entity type:Individual
Prefix:MR
First Name:SATISH
Middle Name:K
Last Name:ANGRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10801 LOCKWOOD DR STE 280
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-1556
Mailing Address - Country:US
Mailing Address - Phone:301-593-3400
Mailing Address - Fax:301-681-0715
Practice Address - Street 1:10801 LOCKWOOD DR STE 280
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-1556
Practice Address - Country:US
Practice Address - Phone:301-593-3400
Practice Address - Fax:301-681-0715
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD046054208000000X
MDD0036980207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD071751700Medicaid
MD071751700Medicaid
MD565115Medicare ID - Type Unspecified