MEDICARE: DR. LUIS ANTONIO SANTIAGO-ROSADO M.D.

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
1	208600000X	Surgery Physician	MD25056	ME

General Provider Information

NPI Number	:	1366739674
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUIS ANTONIO SANTIAGO-ROSADO M.D.

Provider Business Mailing Address
First Line	:	37 PALMER ST STE 1A
Second Line	:
City	:	CALAIS
State	:	ME
Zip	:	04619-1341
Country	:	US
Telephone Number	:	207-454-8432
Fax Number	:	207-454-3616

Provider Business Practice Location Address
First Line	:	37 PALMER ST STE 1A
Second Line	:
City	:	CALAIS
State	:	ME
Zip	:	04619-1341
Country	:	US
Telephone Number	:	207-454-8432
Fax Number	:	207-454-3616

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2011
Last Update Date	:	09/22/2021

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Directions to “ DR. LUIS ANTONIO SANTIAGO-ROSADO M.D.” Practice Location

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