Provider Demographics
NPI:1144249806
Name:DELOS SANTOS, EDGAR RAY (MD)
Entity type:Individual
Prefix:DR
First Name:EDGAR
Middle Name:RAY
Last Name:DELOS 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 1:1604 PINEHURST DR
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-7976
Mailing Address - Country:US
Mailing Address - Phone:419-420-9886
Mailing Address - Fax:
Practice Address - Street 1:1900 S. MAIN ST.
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1239
Practice Address - Country:US
Practice Address - Phone:419-423-5301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35084637207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2490059Medicaid
OH111106Medicare UPIN