Individual
DR. SHANKAR SANTHANAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1950 BRUNSWICK AVE, LAWRENCEVILLE, NJ 08648
(609) 392-6366
(609) 581-9082
Mailing address
1950 BRUNSWICK AVE, LAWRENCEVILLE, NJ 08648-4647
(609) 392-6366
(609) 581-9082
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA07943800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100258258602
—
NJ
05
—
25 MA07930ANT
—
NJ
05
—
60059587
—
NJ
Enumeration date
09/30/2005
Last updated
09/09/2014
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