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General NPI Number Information
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NPI Number | 1790051134
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Entity Type | Individual
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Provider Name | ROBERTO CANDELARIA-SANTIAGO M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/29/2012
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 115 PURPLE HEART AVE
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City | DOVER
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State | DE
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Zip | 19902-5051
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Country | US
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Telephone | 302-346-8724
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Fax |
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Provider Business Mailing Address
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Address Line | 8901 WISCONSIN AVE
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City | BETHESDA
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State | MD
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Zip | 20889-2095
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Country | US
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Telephone | 301-295-4000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 78172
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 27995
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 27995
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License Number State | NE
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