Organization
KOKOMO SURGICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANNEMARIE P DESANTO M.D. (PARTNER)
(765) 456-1790
Entity
Organization
Contact information
Practice address
2000 W BOULEVARD, KOKOMO, IN 46902-6079
(765) 456-1790
(765) 457-3561
Mailing address
2000 W BOULEVARD, KOKOMO, IN 46902-6079
(765) 456-1790
(765) 457-3561
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100420490
—
IN
Enumeration date
02/27/2007
Last updated
10/20/2009
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