Bautista-Santos, Maria Editha M

Bautista-Santos, Maria Editha M is an individual health care provider with primary practice located at 3329 N Richmond St , Appleton WI 54911-1063. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Bautista-Santos, Maria Editha M can be contacted via phone (920) 380-2715.

Contact Information

Primary practice address
3329 N Richmond St Appleton WI 54911-1063
Phone: (920) 380-2715
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 42521 Wisconsin

Profile Details

NPI number 1386638393
LBN Legal business name Bautista-Santos, Maria Editha M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 6th, 2005
Last updated Aug 28th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386638393 NPPES
Wisconsin MEDICAID 34235100

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