Basic Information
Provider Information
NPI: 1033444245
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DIXIT
FirstName: SANTOSH
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 23920 MIDDLEBELT RD
Address2: APT 3305
City: FARMINGTON HILLS
State: MI
PostalCode: 483362961
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 28050 GRAND RIVER AVE
Address2: MEDICAL EDUCATION
City: FARMINGTON HILLS
State: MI
PostalCode: 483365919
CountryCode: US
TelephoneNumber: 2484718000
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/06/2009
LastUpdateDate: 02/19/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/19/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XP3144TXY Allopathic & Osteopathic PhysiciansEmergency Medicine 
207P00000X5101017992MIN Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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