Basic Information
| Provider Information | |||||||||
| NPI: | 1639210222 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | POOBALASINGHAM | ||||||||
| FirstName: | SATHIYENDRAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5716 BOULIA DR | ||||||||
| Address2: | |||||||||
| City: | CLAY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 130416922 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3159359318 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2002 BROOKSIDE DR | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | KINGSPORT | ||||||||
| State: | TN | ||||||||
| PostalCode: | 376604634 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4232456000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/08/2007 | ||||||||
| LastUpdateDate: | 11/21/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | 01059186A | IN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.