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General NPI Number Information
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NPI Number | 1891809893
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Entity Type | Organization
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Legal Business Name | MICHAEL CHRISTOPHER DESANTIS
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 01/26/2024
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Provider Practice Location Address
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Address Line | 608 46TH AVENUE DR NE
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City | HICKORY
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State | NC
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Zip | 28601-7318
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Country | US
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Telephone | 828-320-2972
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Fax | 828-465-0811
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Provider Business Mailing Address
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Address Line | 608 46TH AVENUE DR NE
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City | HICKORY
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State | NC
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Zip | 28601-7318
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Country | US
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Telephone | 828-304-6363
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Fax | 828-304-0033
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Authorized Official
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Title or Position | PARTNER
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Name | DR. MICHAEL CHRISTOPHER DESANTIS
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Credential | MD
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Telephone | 828-304-6363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 9800233
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License Number State | NC
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