Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 20792 | WV |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 28473 | SC |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 35.08143 | OH |
NPI | 1497731780 |
---|---|
Provider Name | Dr. Robert D Santrock |
First Address | Worthington, OH 43085-2591 |
Second Address | Worthington, OH 43085-2591 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2005 |
Last Update Date | 07/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H73179 | (02) |