Basic Information
| Provider Information | |||||||||
| NPI: | 1366423196 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SANTOS | ||||||||
| FirstName: | MARCIAL | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 370 FAUNCE CORNER ROAD | ||||||||
| Address2: | SOUTHCOAST PHYSICIAN SERVICES INC | ||||||||
| City: | NORTH DARTMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02747 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5089852000 | ||||||||
| FaxNumber: | 5089852001 | ||||||||
| Practice Location | |||||||||
| Address1: | 101 PAGE STREET | ||||||||
| Address2: | SOUTHCOAST PHYSICIAN SERVICES INC | ||||||||
| City: | NEW BEDFORD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02740 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5089615919 | ||||||||
| FaxNumber: | 5089615916 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2005 | ||||||||
| LastUpdateDate: | 06/10/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 225848 | MA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 225848 | MA | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.