Ronald J De Santo, CPED
Individual provider Active NPI Specialist · Southport, NC
NPI 1336330703 · NPPES record last updated Aug 9, 2007
Key facts
- NPI
- 1336330703
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- CPED1438 (NC)
- Practice address
- 1635 N Howe St
Ste H
Southport, NC 28461 - Phone
- (910) 454-4545
- Fax
- (910) 454-0122
- NPI assigned
- Aug 9, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CPED1438 | NC | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolina Healthcare Products, Inc | Past | Accepting new patients | |
| Carolina Healthcare Products, Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | CPED1438 | NC | Yes |
Addresses
Primary practice location
1635 N Howe St
Ste H
Southport, NC 28461
Mailing address
1635 N Howe St
Ste H
Southport, NC 28461
Phone (910) 454-4545
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7795071 | Medicaid | NC |
Other providers in Southport, NC
- Michael J Curtin
- Cypress Chiropractic, PA
- Lisa D'Oria
- Davies Southport Chiropractic PLLC
- David Jason Davies
- Susan Jane Dean
- Pamela R Dehne
- Seth M Deletetsky
- Eugene W Deslauriers
- Christopher Michael Dillard
All providers in Southport, NC · Specialist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.