1487624763 NPI number — RAMON D SANTOS MD

Table of content: RAMON D SANTOS MD (NPI 1487624763)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487624763 NPI number — RAMON D SANTOS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SANTOS
Provider First Name:
RAMON
Provider Middle Name:
D
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487624763
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/21/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1699 WASHINGTON RD
Provider Second Line Business Mailing Address:
STE 307
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15228-1629
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-831-3744
Provider Business Mailing Address Fax Number:
412-831-5663

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 NOLTE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KITTANNING
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16201-7111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-543-8500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/26/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  MD035055L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)