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Individual

JAMES M DESANTIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
400 WESTPARK CT, STE 230, PEACHTREE CITY, GA 30269-3571
(770) 631-8478
(770) 631-8473
Mailing address
10247 HIGHWAY 92, APT 402, WOODSTOCK, GA 30188-3914
(678) 361-3028

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
25650
AL
207P00000X
Emergency Medicine Physician
MD027124E
PA
207P00000X
Emergency Medicine Physician
Primary
P1452
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009912277
AL
01
051542232
BCBS
AL
01
10577706
CAQH
01
4295661
AETNA
AL
Enumeration date
05/24/2006
Last updated
12/19/2016
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