Individual
RENATO MARIA SANTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
074580
GA
207RC0000X
Cardiovascular Disease Physician
9400338
NC
207RI0011X
Interventional Cardiology Physician
Primary
74580
GA
207RI0011X
Interventional Cardiology Physician
9400338
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10080398
—
VA
01
—
1054N
BCBS
—
01
—
17623
PARTNERS
—
05
—
3810000702
—
WV
01
—
5381507
AETNA
—
05
—
891054N
—
NC
01
—
D5917
MEDCOST
—
01
—
P00159776
RR MEDICARE
—
Enumeration date
12/09/2005
Last updated
06/24/2019
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