Provider Demographics
NPI:1821871427
Name:SADASHIV SANTOSH MD LLC
Entity Type:Organization
Organization Name:SADASHIV SANTOSH MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SADASHIV
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTOSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:607-237-1841
Mailing Address - Street 1:725 W FRESHWATER WAY APT 109
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53204-4123
Mailing Address - Country:US
Mailing Address - Phone:607-237-1841
Mailing Address - Fax:
Practice Address - Street 1:2301 N LAKE DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53211-4508
Practice Address - Country:US
Practice Address - Phone:414-585-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty