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General NPI Number Information
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NPI Number | 1902901507
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Entity Type | Individual
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Provider Name | STEVEN MICHAEL SANTILLI MD
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Gender | Male
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 516 DELAWARE STREET SE PWB 1ST FLOOR, CLINIC 1E
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City | MINNEAPOLIS
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State | MN
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Zip | 55454
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Country | US
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Telephone | 612-626-6666
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Fax |
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Provider Business Mailing Address
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Address Line | UNIVERSITY OF MINNESOTA PHYSICIANS 420 DELAWARE STREET SE, MMC 292
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City | MINNEAPOLIS
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State | MN
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Zip | 55455
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Country | US
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Telephone | 612-626-6666
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 30180
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License Number State | MN
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