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NPI Code Detail

MEDICARE: MIQUEL ANGEL SANTIAGO

MEDICARE: MIQUEL ANGEL SANTIAGO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice Physician7279AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
151004314OTHERALBCBS
2P00192500OTHERALRAILROAD
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174547970
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIQUEL ANGEL SANTIAGO
Provider Business Mailing Address
First Line : PO BOX 70365
Second Line :
City : MONTGOMERY
State : AL
Zip : 36107-0365
Country : US
Telephone Number : 334-420-5001
Fax Number : 334-420-0146
Provider Business Practice Location Address
First Line : 1845 CHERRY ST
Second Line :
City : MONTGOMERY
State : AL
Zip : 36107-2613
Country : US
Telephone Number : 334-263-2301
Fax Number : 334-263-0886
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2006
Last Update Date : 03/05/2014

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Directions to “ MIQUEL ANGEL SANTIAGO ” Practice Location

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