Provider Demographics
NPI:1144297730
Name:ABAD SANTOS, JOSE S (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:S
Last Name:ABAD SANTOS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:W227N6103 SUSSEX RD
Mailing Address - Street 2:
Mailing Address - City:SUSSEX
Mailing Address - State:WI
Mailing Address - Zip Code:53089-3969
Mailing Address - Country:US
Mailing Address - Phone:414-566-6400
Mailing Address - Fax:414-566-3866
Practice Address - Street 1:W227N6103 SUSSEX RD
Practice Address - Street 2:
Practice Address - City:SUSSEX
Practice Address - State:WI
Practice Address - Zip Code:53089-3969
Practice Address - Country:US
Practice Address - Phone:414-566-6400
Practice Address - Fax:414-566-3866
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI34691-020208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIG58678Medicare UPIN