Healthcare Provider Details

I. General information

NPI: 1356171730
Provider Name (Legal Business Name): EMELIA B. SANTAMARIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2024
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 DR. PAUL TURNER DRIVE
PAGO PAGO AMERICAN SAMOA
96799
UM

IV. Provider business mailing address

1 DR. PAUL TURNER DRIVE
PAGO PAGO AMERICAN SAMOA
96799
UM

V. Phone/Fax

Practice location:
  • Phone: 684-633-1222
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number5127C
License Number StateAS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: