Individual
DR. IGMIDIO A SANTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1237 W DIVIDE AVE, STE 5, BISMARCK, ND 58501-1208
(701) 328-8888
(701) 328-8900
Mailing address
1237 W DIVIDE AVE, STE 5, BISMARCK, ND 58501-1208
(701) 328-8888
(701) 328-8900
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4316
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15477
—
ND
01
—
260025765
MEDICARE PTAN
ND
Enumeration date
11/16/2005
Last updated
06/30/2011
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