# RICHARD A. DE SANTIS, PH.D., M.D., P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447560834
- **Authorized official:** DR. RICHARD ANTHONY DE SANTIS M.D. (PRESIDENT)
- **Authorized official phone:** (410) 838-5208

## Contact information

- **Practice address:** 715 S SHAMROCK RD, BEL AIR, MD 21014-4457
- **Practice address phone:** (410) 838-5208
- **Practice address fax:** (410) 838-6129
- **Mailing address:** 715 S SHAMROCK RD, BEL AIR, MD 21014-4457
- **Mailing address phone:** (410) 838-5208
- **Mailing address fax:** (410) 838-6129

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | D40938 | MD | Yes |

## Other

- **Enumeration date:** 10/19/2010
- **Last updated:** 10/19/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 698491600 | — | MD |