Organization
RICHARD A. DE SANTIS, PH.D., M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD ANTHONY DE SANTIS M.D. (PRESIDENT)
(410) 838-5208
Entity
Organization
Contact information
Practice address
715 S SHAMROCK RD, BEL AIR, MD 21014-4457
(410) 838-5208
(410) 838-6129
Mailing address
715 S SHAMROCK RD, BEL AIR, MD 21014-4457
(410) 838-5208
(410) 838-6129
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
D40938
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
698491600
—
MD
Enumeration date
10/19/2010
Last updated
10/19/2010
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