Provider Demographics
NPI:1366423196
Name:SANTOS, MARCIAL A (MD)
Entity type:Individual
Prefix:DR
First Name:MARCIAL
Middle Name:A
Last Name:SANTOS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:370 FAUNCE CORNER ROAD
Mailing Address - Street 2:SOUTHCOAST PHYSICIAN SERVICES INC
Mailing Address - City:NORTH DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747
Mailing Address - Country:US
Mailing Address - Phone:508-985-2000
Mailing Address - Fax:508-985-2001
Practice Address - Street 1:101 PAGE STREET
Practice Address - Street 2:SOUTHCOAST PHYSICIAN SERVICES INC
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740
Practice Address - Country:US
Practice Address - Phone:508-961-5919
Practice Address - Fax:508-961-5916
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2009-06-10
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Provider Licenses
StateLicense IDTaxonomies
MA225848207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
M20518Medicare PIN
A3915701Medicare PIN