Doctor Name: | MARIBEL COLON-SANTIAGO |
NPI Number: | 1942312103 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 10773 |
Business Practice Address: | 1515 Ne Lawrie Tatum Rd Lawton, OK - 735073002 |
Business Phone Number: | 5803545270 |
Business Fax Number: | 5803545289 |
Mailing Address: | 2112 Nw 55th St, LAWTON |
State: | OK |
Postal Code: | 735053118 |
Phone Number: | 5802480972 |
Fax Number: | 5802480972 |
NPI Enumeration Date: | 08/31/2006 |
NPI Last Update Date: | 10/27/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 10773 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |