Healthcare Provider Details

I. General information

NPI: 1053234666
Provider Name (Legal Business Name): MICHAEL SANTOME RN, BSN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1369 BRASS MILL RD
BELCAMP MD
21017-1238
US

IV. Provider business mailing address

719 IDLEWILD RD
BEL AIR MD
21014-4422
US

V. Phone/Fax

Practice location:
  • Phone: 440-822-5188
  • Fax:
Mailing address:
  • Phone: 443-843-8279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberR201620
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: