Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD035561L | PA |
NPI | 1053377705 |
---|---|
Provider Name | Arthur Magno Santos |
First Address | Neweagle, PA 15067 |
Second Address | Charleroi, PA 15022 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2006 |
Last Update Date | 08/07/2007 |