Provider Demographics
NPI:1184829855
Name:SANTIN, AMY JO (MD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:JO
Last Name:SANTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:119 HENDERSONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2868
Mailing Address - Country:US
Mailing Address - Phone:828-257-4730
Mailing Address - Fax:828-257-4738
Practice Address - Street 1:1542 CANE CREEK RD
Practice Address - Street 2:
Practice Address - City:FLETCHER
Practice Address - State:NC
Practice Address - Zip Code:28732
Practice Address - Country:US
Practice Address - Phone:828-628-8250
Practice Address - Fax:828-628-8633
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2018-06-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC201000076207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5917142Medicaid
NC1184829855Medicaid
NCNCC569AMedicare PIN
NC2077433Medicare PIN