Healthcare Provider Details

I. General information

NPI: 1952443194
Provider Name (Legal Business Name): CONRAD DE LOS SANTOS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

995 9TH AVE SW
BESSEMER AL
35022-4527
US

IV. Provider business mailing address

4240 GAINES MILL RD
MOUNTAIN BRK AL
35213-1824
US

V. Phone/Fax

Practice location:
  • Phone: 205-313-5262
  • Fax: 205-313-5245
Mailing address:
  • Phone: 205-870-1546
  • Fax: 205-313-5245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberDO728
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: