Provider Demographics
NPI:1649218843
Name:SANTANGELO, ANDRE FRANCIS (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDRE
Middle Name:FRANCIS
Last Name:SANTANGELO
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 1:3004 NEVAN LN
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-6468
Mailing Address - Country:US
Mailing Address - Phone:910-239-9074
Mailing Address - Fax:910-239-9547
Practice Address - Street 1:6801 PARKER FARM DR STE 130
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-8358
Practice Address - Country:US
Practice Address - Phone:910-239-9074
Practice Address - Fax:910-239-9547
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3165111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC085NCOtherBCBS
NC89085Medicaid
2456511BMedicare ID - Type Unspecified
U95429Medicare UPIN