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Individual

MRS. YOLANDA A SANTOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
106 HAWTHORN LN, DANIELS, WV 25832-9269
(304) 763-3674
Mailing address
PO BOX 580, BECKLEY, WV 25802-0580
(304) 763-3674

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
13221
WV
208D00000X
General Practice Physician
13221
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001720560
BC
WV
05
0048997000
WV
01
080141780
W COMP
WV
Enumeration date
10/31/2005
Last updated
10/16/2012
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