MEDICARE: JOS R SANTZ I MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	2005-01471	NC

General Provider Information

NPI Number	:	1700116498
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOS R SANTZ I MD PC

Provider Business Mailing Address
First Line	:	PO BOX 87736
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-7736
Country	:	US
Telephone Number	:	910-496-5077
Fax Number	:

Provider Business Practice Location Address
First Line	:	514 BEAUMONT RD
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-4443
Country	:	US
Telephone Number	:	910-485-8831
Fax Number	:	910-485-8832

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOS SANTZ I
Credential	:	MD
Telephone Number	:	910-496-5077

Provider Enumeration Date	:	01/03/2010
Last Update Date	:	01/03/2010

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