Provider Demographics
NPI:1639272073
Name:SANTOLI, FRANK ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:ANTHONY
Last Name:SANTOLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24988 SE STARK ST STE 104
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-8322
Mailing Address - Country:US
Mailing Address - Phone:971-262-9500
Mailing Address - Fax:971-262-9501
Practice Address - Street 1:24988 SE STARK ST STE 104
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-8322
Practice Address - Country:US
Practice Address - Phone:971-262-9500
Practice Address - Fax:971-262-9501
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD177711207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL35703OtherBCBS
FL259392100Medicaid
FL35703OtherBCBS