Individual
CHARITO M SANTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13819 HANSON BLVD NW, ANDOVER, MN 55304-7608
(763) 392-4001
Mailing address
13819 HANSON BLVD NW, ANDOVER, MN 55304-7608
(763) 392-4001
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
54594
WI
207Q00000X
Family Medicine Physician
54594
WI
207Q00000X
Family Medicine Physician
Primary
58448
MN
207Q00000X
Family Medicine Physician
MT189896
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013103332
—
WI
Enumeration date
09/20/2007
Last updated
12/01/2015
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