Active NPI
Satish Maryala, M.D.
- Gastroenterology Physician
- Detroit, MI
National Provider Identifier
1881633170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 4301070422
- Practice address
- 4160 John R St
Suite 917
Detroit, MI 48201-2020 - Phone
- (313) 745-4525
- NPI assigned
- Jun 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 4301070422 | MI | Primary |
Addresses
Primary practice location
4160 John R St
Suite 917
Detroit, MI 48201-2020
Mailing address
3800 Woodward Ave.
Suite 702
Detroit, MI 48201-2064
Phone (313) 262-1303
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301070422 | MI | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1881633170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3800 WOODWARD AVE.",
"address_2": "SUITE 702",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012064",
"telephone_number": "313-262-1303",
"fax_number": "313-262-1238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4160 JOHN R ST",
"address_2": "SUITE 917",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012020",
"telephone_number": "313-745-4525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARYALA",
"first_name": "SATISH",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "MI",
"license": "4301070422",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.