Provider Demographics
NPI:1336220623
Name:SANTOGADE, PETER J (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:J
Last Name:SANTOGADE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 N CHURCH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1439
Mailing Address - Country:US
Mailing Address - Phone:336-378-0713
Mailing Address - Fax:336-273-9060
Practice Address - Street 1:1002 N CHURCH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1439
Practice Address - Country:US
Practice Address - Phone:336-378-0713
Practice Address - Fax:336-273-9060
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI33198207RG0100X
NC9801047207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89940OtherMEDCOST
NC891163PMedicaid
NC1163POtherBCBS OF NC
NC26292OtherPARTNERS MEDICARE
NC891163PMedicaid
NC2260923CMedicare ID - Type UnspecifiedMEDICARE