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NPI Code Detail

MEDICARE: DR. CARLOS SORIANO SANTIAGO III MD

MEDICARE:  DR. CARLOS SORIANO SANTIAGO III MD
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
1208VP0014XInterventional Pain Medicine PhysicianD0027107MD

General Provider Information

NPI Number : 1306891148
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CARLOS SORIANO SANTIAGO III MD
Provider Business Mailing Address
First Line : 11350 MCCORMICK RD
Second Line : EXECUTIVE PLAZA 1, SUITE 501
City : HUNT VALLEY
State : MD
Zip : 21031-1002
Country : US
Telephone Number : 301-777-2543
Fax Number : 301-777-2583
Provider Business Practice Location Address
First Line : 940 SETON DR
Second Line : SUITE A
City : CUMBERLAND
State : MD
Zip : 21502-1818
Country : US
Telephone Number : 301-777-2543
Fax Number : 301-777-2583
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2006
Last Update Date : 02/21/2017

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Directions to “ DR. CARLOS SORIANO SANTIAGO III MD” Practice Location

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