Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 30944 | MA |
NPI | 1023037678 |
---|---|
Provider Name | John C Santos |
First Address | Salem, MA 01970-1738 |
Second Address | Salem, MA 01970-1738 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 15/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2022664 | (05) | MA |
B76299 | (02) | MA |