Healthcare Provider Details

I. General information

NPI: 1932178050
Provider Name (Legal Business Name): SANTOS ERIC MARTIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 03/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 OGLETOWN STANTON RD SUITE 3400
NEWARK DE
19713-2055
US

IV. Provider business mailing address

4701 OGLETOWN STANTON RD SUITE 3400
NEWARK DE
19713-2055
US

V. Phone/Fax

Practice location:
  • Phone: 302-366-1200
  • Fax: 302-366-1700
Mailing address:
  • Phone: 302-366-1200
  • Fax: 302-366-1700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberCI0002228
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: