Individual
ANNETTE G DESANTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
18181 OAKWOOD BLVD, SUITE 411, DEARBORN, MI 48124-5032
(313) 438-7373
(313) 438-7375
Mailing address
1420 STEPHENSON HWY, SUITE 400--CREDENTIALING, TROY, MI 48083-1189
(248) 581-5974
(248) 581-5640
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
AD042312
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2505035481
BCBS
—
Enumeration date
05/25/2006
Last updated
11/04/2013
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