| Doctor Name: | DESIREE SANTIAGO |
| NPI Number: | 1154777183 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | AS820379695 |
| Business Practice Address: | 517 Graten St Birmingham, MI - 480096519 |
| Business Phone Number: | 2489524011 |
| Business Fax Number: | 2482820455 |
| Mailing Address: | 517 Graten St, BIRMINGHAM |
| State: | MI |
| Postal Code: | 480096519 |
| Phone Number: | 2489524011 |
| Fax Number: | 2482820455 |
| NPI Enumeration Date: | 05/09/2016 |
| NPI Last Update Date: | 05/09/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 305R00000X |
| License Number: | AS820379695 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Managed Care Organizations |
| Taxonomy Classification: | Preferred Provider Organization |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |