Individual
ANGELA DESANTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1700 BIDDLE AVE, WYANDOTTE, MI 48192-7205
(734) 284-2026
(734) 284-8335
Mailing address
3200 GREENFIELD RD, SUITE 250, DEARBORN, MI 48120-1802
(313) 563-3332
(313) 563-3342
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301052721
MI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
4301052721
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110H211300
BCBS MI
MI
05
—
297792310
—
MI
Enumeration date
08/30/2006
Last updated
02/13/2014
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