Provider Demographics
NPI:1851625438
Name:SANTO, JOHN M (DPM)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:SANTO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 DENNETT DR
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-3303
Mailing Address - Country:US
Mailing Address - Phone:978-255-1234
Mailing Address - Fax:
Practice Address - Street 1:5 DENNETT DR
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-3303
Practice Address - Country:US
Practice Address - Phone:978-255-1234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1859213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y70868Medicare PIN
T58800Medicare UPIN