Individual
DR. MARK LOUIS DE SANTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
109 BEE ST, CHARLESTON, SC 29401-5703
(954) 465-8136
Mailing address
9859 NW 3RD CT, PLANTATION, FL 33324-7079
(954) 465-8136
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
Other
Enumeration date
10/16/2007
Last updated
10/16/2007
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