Provider Demographics
NPI:1467414185
Name:DAS, SANTHI K (MD)
Entity Type:Individual
Prefix:DR
First Name:SANTHI
Middle Name:K
Last Name:DAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1306 OLD ORRVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:AL
Mailing Address - Zip Code:36701-6931
Mailing Address - Country:US
Mailing Address - Phone:334-877-3322
Mailing Address - Fax:334-877-3322
Practice Address - Street 1:1306 OLD ORRVILLE RD
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:AL
Practice Address - Zip Code:36701-6931
Practice Address - Country:US
Practice Address - Phone:334-877-3322
Practice Address - Fax:334-877-3322
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL45642084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL101500037OtherAL. PSY. SERVICE PROVIDER
AL103386OtherVALUE OPTION PROVIDER #
AL4225823OtherAETNA PROVIDER NUMBER
AL0515-14303OtherBLUE CROSS PROVIDER #
AL123959Medicaid
AL260005586OtherM'CARE RAILROAD PROVIDER
AL101500037OtherAL. PSY. SERVICE PROVIDER
AL0515-14303OtherBLUE CROSS PROVIDER #