Organization Name: | ROBERT SANTIAGO, MD, INC. |
NPI Number: | 1578731972 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DIANNE SANTIAGO (CO-OWNER) |
Mailing Address: | 396 Portland Way N Galion |
State: | OH US |
Postal Code: | 448331115 |
Phone Number: | 4194625543 |
Fax Number: | 4194622058 |
NPI Enumeration Date: | 02/19/2008 |
NPI Last Update Date: | 02/19/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 35-05-7517 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |