MEDICARE: SANTIAGO DUY 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	MD15503	ME

General Provider Information

NPI Number	:	1437127255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANTIAGO DUY M.D.

Provider Business Mailing Address
First Line	:	20 HARTFORD ST
Second Line	:
City	:	HOULTON
State	:	ME
Zip	:	04730-1891
Country	:	US
Telephone Number	:	207-532-7936
Fax Number	:	207-532-7937

Provider Business Practice Location Address
First Line	:	20 HARTFORD ST
Second Line	:
City	:	HOULTON
State	:	ME
Zip	:	04730-1891
Country	:	US
Telephone Number	:	207-532-7936
Fax Number	:	207-532-7937

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

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	05/10/2017

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