Provider Demographics
NPI:1417929266
Name:SANTJER, ERIC C (DC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:C
Last Name:SANTJER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 KEMPSVILLE RD
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3715
Mailing Address - Country:US
Mailing Address - Phone:757-547-2045
Mailing Address - Fax:757-547-2027
Practice Address - Street 1:115 KEMPSVILLE RD
Practice Address - Street 2:SUITE ONE
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3715
Practice Address - Country:US
Practice Address - Phone:757-547-2045
Practice Address - Fax:757-547-2027
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000885111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA300721Medicaid
433612OtherBLUS CROSS BLUE SHIELD VA
4383925OtherAETNA