Individual
JOHN A DESANTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13050 PARKSIDE DR STE 101, FISHERS, IN 46038-8247
(317) 621-2290
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2890
(317) 355-2184
(317) 355-2185
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01038336A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100354250
—
IN
Enumeration date
07/26/2006
Last updated
12/26/2024
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