Individual
DAVID DESANTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D
Contact information
Practice address
2200 W MAIN ST, RICHMOND, IN 47374-3882
(765) 973-9294
(765) 973-9233
Mailing address
1100 REID PKWY, MEDICAL STAFF SERVICES, RICHMOND, IN 47374-1157
(765) 935-8860
(765) 935-8859
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01044050
IN
207Q00000X
Family Medicine Physician
35.065370
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000681665
ANTHEM
IN
05
—
0943797
—
OH
01
—
110144521
MEDICARE RR
IN
05
—
200043690A
—
IN
01
—
DEC36280
CSHCS
IN
01
—
P00875846
MEDICARE RR
IN
Enumeration date
09/13/2005
Last updated
04/28/2026
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