MEDICARE: LAURA SANTORO M.D.

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
1	207P00000X	Emergency Medicine Physician	4301103429	MI
2	207Q00000X	Family Medicine Physician	4301103429	MI

General Provider Information

NPI Number	:	1568800480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA SANTORO M.D.

Provider Business Mailing Address
First Line	:	5089 US 41 S
Second Line	:
City	:	MARQUETTE
State	:	MI
Zip	:	49855-9001
Country	:	US
Telephone Number	:	906-249-5589
Fax Number	:	231-935-8099

Provider Business Practice Location Address
First Line	:	5089 US 41 S
Second Line	:
City	:	MARQUETTE
State	:	MI
Zip	:	49855-9001
Country	:	US
Telephone Number	:	906-249-5589
Fax Number	:	231-935-8099

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2013
Last Update Date	:	08/10/2023

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