Basic Information
| Provider Information | |||||||||
| NPI: | 1588923395 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DEL SANTO | ||||||||
| FirstName: | MOLLY | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5051 GREENSPRING AVE STE 300 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212094358 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4106019515 | ||||||||
| FaxNumber: | 4106018905 | ||||||||
| Practice Location | |||||||||
| Address1: | 5051 GREENSPRING AVE | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212094354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4106019515 | ||||||||
| FaxNumber: | 4106018905 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/14/2012 | ||||||||
| LastUpdateDate: | 03/29/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | MD.32952 | AL | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 2084N0400X | D0082917 | MD | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.