Healthcare Provider Details

I. General information

NPI: 1427111848
Provider Name (Legal Business Name): ROXANNA MAGALIE TORRES-SANTIAGO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 10/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3158 WEST ST
WEIRTON WV
26062-4637
US

IV. Provider business mailing address

200 LURAY DR
STEUBENVILLE OH
43953-3973
US

V. Phone/Fax

Practice location:
  • Phone: 304-797-7733
  • Fax: 330-385-9672
Mailing address:
  • Phone: 740-314-8258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35084067-T
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: