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General NPI Number Information
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NPI Number | 1659466878
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Entity Type | Individual
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Provider Name | DOMICIANO J SANTOS MD
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Gender | Male
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 111 MICHIGAN AVE NW
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City | WASHINGTON
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State | DC
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Zip | 20010-2978
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Country | US
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Telephone | 202-884-2025
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Fax |
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Provider Business Mailing Address
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Address Line | 111 MICHIGAN AVE NW
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City | WASHINGTON
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State | DC
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Zip | 20010-2978
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Country | US
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Telephone | 202-884-2025
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP3000X
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Taxonomy Name | Pediatric Anesthesiology Physician
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License Number | D73360
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207LP3000X
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Taxonomy Name | Pediatric Anesthesiology Physician
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License Number | MD035391
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License Number State | DC
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