Individual
JASON A DOS SANTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
500 UNIVERSITY DR, HERSHEY, PA 17033-2360
(800) 243-1455
Mailing address
4043 WATERFORD DR, CENTER VALLEY, PA 18034-8692
(610) 476-9270
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA051874
PA
363AS0400X
Surgical Physician Assistant
MA051874
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2001087
KEYSTONE SENIOR BLUE
PA
01
—
50048830
CAPITAL BLUE CROSS
PA
Enumeration date
08/12/2005
Last updated
03/06/2023
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