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Individual

DONALD DESANTIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
552A LANCASTER AVE, BERWYN, PA 19312-1635
(610) 644-7100
(610) 644-7111
Mailing address
552A LANCASTER AVE, BERWYN, PA 19312-1635
(610) 644-7100
(610) 644-7111

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
200200107
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
137P1
BCBS NUMBER
NC
01
1700922
UNITED HEALTHCARE NUMBER
NC
01
2130600
MAMSI NUMBER
NC
01
4087699
AETNA NUMBER
NC
01
5435826
CIGNA NUMBER
NC
01
804764
PARTNERS MEDICARE CHOICE
NC
05
89137P1
NC
01
D5599
MEDCOST NUMBER
NC
Enumeration date
02/24/2006
Last updated
04/10/2017
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