Provider Demographics
NPI:1063420628
Name:SANTOS, DELFIN (MD)
Entity type:Individual
Prefix:DR
First Name:DELFIN
Middle Name:
Last Name:SANTOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 BARCLAY CIRCLE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307
Mailing Address - Country:US
Mailing Address - Phone:248-852-2277
Mailing Address - Fax:248-852-2552
Practice Address - Street 1:135 BARCLAY CIRCLE
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307
Practice Address - Country:US
Practice Address - Phone:248-852-2277
Practice Address - Fax:248-852-2552
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301059096207RR0500X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty