Provider Demographics
NPI:1407608581
Name:DOMINGOS DOS SANTOS, INALDO (MD)
Entity Type:Individual
Prefix:
First Name:INALDO
Middle Name:
Last Name:DOMINGOS DOS SANTOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:INALDO
Other - Middle Name:
Other - Last Name:SANTOS
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:801 OSTRUM ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1000
Mailing Address - Country:US
Mailing Address - Phone:484-503-8217
Mailing Address - Fax:484-503-0239
Practice Address - Street 1:801 OSTRUM ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-1000
Practice Address - Country:US
Practice Address - Phone:484-503-8217
Practice Address - Fax:484-503-0239
Is Sole Proprietor?:No
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT230500207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology