Desantis, David
Desantis, David is an individual health care provider with primary practice located at 1350 Chester Blvd Ste D , Richmond IN 47374-1960. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Desantis, David can be contacted via phone (765) 935-8860.Contact Information
Primary practice address
1350 Chester Blvd Ste D
Richmond IN 47374-1960
Phone: (765) 935-8860
Fax: (765) 935-5589
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 35.065370 | Ohio |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 01044050 | Indiana |
Profile Details
| NPI number | 1467447748 |
|---|---|
| LBN Legal business name | Desantis, David |
| Credentials | M.D., PH.D |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 13th, 2005 |
| Last updated | May 13th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467447748 | NPPES |
| Indiana | Other | 110144521 | MEDICARE RR |
| Indiana | Other | P00875846 | MEDICARE RR |
| Indiana | Other | DEC36280 | MEDICARE RR |
| Indiana | Other | 000000681665 | MEDICARE RR |
| Indiana | MEDICAID | 0943797 | MEDICARE RR |
| Indiana | MEDICAID | 200043690A | MEDICARE RR |
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