Individual
DR. GANESHA SANTHYADKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
360 BROADWAY, BANGOR, ME 04401-3979
(207) 907-1155
(207) 907-1888
Mailing address
C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT, PO BOX 7291, LEWISTON, ME 04243-7291
(207) 777-8560
(207) 777-8800
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD17150
ME
207RP1001X
Pulmonary Disease Physician
Primary
MD17150
ME
Other
Enumeration date
07/05/2006
Last updated
02/03/2022
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